Provider Demographics
NPI:1316320658
Name:CARROLL, EILEEN FRANCES (PHARMD, RPH)
Entity type:Individual
Prefix:
First Name:EILEEN
Middle Name:FRANCES
Last Name:CARROLL
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 BAYWOOD CT
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-4508
Mailing Address - Country:US
Mailing Address - Phone:812-344-8524
Mailing Address - Fax:
Practice Address - Street 1:915 BAYWOOD CT
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:IN
Practice Address - Zip Code:47201-4508
Practice Address - Country:US
Practice Address - Phone:812-344-8524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-06
Last Update Date:2015-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN26026080A183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist