Provider Demographics
NPI:1992074355
Name:LAWSON, CAROL (RPH)
Entity type:Individual
Prefix:
First Name:CAROL
Middle Name:
Last Name:LAWSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6510 W MOLLY LN
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AR
Mailing Address - Zip Code:85083
Mailing Address - Country:US
Mailing Address - Phone:623-236-8876
Mailing Address - Fax:
Practice Address - Street 1:6510 W MOLLY LN
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85083-6515
Practice Address - Country:US
Practice Address - Phone:623-236-8876
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZS015992183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist