Provider Demographics
NPI:1588947881
Name:PIERCE, CAROL R (PHARMD)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:R
Last Name:PIERCE
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11099 HIGHWAY 44 E
Mailing Address - Street 2:
Mailing Address - City:MT WASHINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40047-6243
Mailing Address - Country:US
Mailing Address - Phone:502-538-4291
Mailing Address - Fax:502-538-4591
Practice Address - Street 1:11099 HIGHWAY 44 E
Practice Address - Street 2:
Practice Address - City:MT WASHINGTON
Practice Address - State:KY
Practice Address - Zip Code:40047-6243
Practice Address - Country:US
Practice Address - Phone:502-538-4291
Practice Address - Fax:502-538-4591
Is Sole Proprietor?:No
Enumeration Date:2011-09-22
Last Update Date:2011-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY0126991835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist