Provider Demographics
NPI:1437979325
Name:CARTER, TAMARIAN LASHAY
Entity type:Individual
Prefix:
First Name:TAMARIAN
Middle Name:LASHAY
Last Name:CARTER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1030 POPLAR AVE APT 39
Mailing Address - Street 2:
Mailing Address - City:MEMPHIS
Mailing Address - State:TN
Mailing Address - Zip Code:38105-4728
Mailing Address - Country:US
Mailing Address - Phone:512-718-4450
Mailing Address - Fax:
Practice Address - Street 1:4264 SUMMER AVE
Practice Address - Street 2:
Practice Address - City:MEMPHIS
Practice Address - State:TN
Practice Address - Zip Code:38122-4044
Practice Address - Country:US
Practice Address - Phone:901-763-0831
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-15
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN48261183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist