Basic Information
| Provider Information | |||||||||
| NPI: | 1336603265 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CARTER | ||||||||
| FirstName: | RAMSEY | ||||||||
| MiddleName: | CHARLES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2122 SIEGLE CT | ||||||||
| Address2: | |||||||||
| City: | LEMON GROVE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 919454253 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6196510780 | ||||||||
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| Practice Location | |||||||||
| Address1: | 350 W THOMAS RD | ||||||||
| Address2: | |||||||||
| City: | PHOENIX | ||||||||
| State: | AZ | ||||||||
| PostalCode: | 850134409 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6024063000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/24/2019 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/18/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 22051 | NV | N | Pharmacy Service Providers | Pharmacist | 183500000X | 1-116491 | KS | N | Pharmacy Service Providers | Pharmacist | 183500000X | 64015 | TX | N | Pharmacy Service Providers | Pharmacist | 183500000X | S024357 | AZ | N | Pharmacy Service Providers | Pharmacist | 183500000X | 79064 | CA | Y | Pharmacy Service Providers | Pharmacist | 1835P0018X | SPCB002474 | AZ | N | Pharmacy Service Providers | Pharmacist | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
No ID Information.