Provider Demographics
NPI:1912472846
Name:TAYLOR, CAROLYN LOUISE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CAROLYN
Middle Name:LOUISE
Last Name:TAYLOR
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 1:400 GATEWAY DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22603-5838
Mailing Address - Country:US
Mailing Address - Phone:540-535-0923
Mailing Address - Fax:540-535-0965
Practice Address - Street 1:400 GATEWAY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22603-5838
Practice Address - Country:US
Practice Address - Phone:540-535-0923
Practice Address - Fax:540-535-0965
Is Sole Proprietor?:No
Enumeration Date:2018-10-08
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVRP0010592183500000X
VA0202216867183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist