Provider Demographics
NPI:1447520002
Name:PIERCE, CARLEEN (RPH)
Entity type:Individual
Prefix:
First Name:CARLEEN
Middle Name:
Last Name:PIERCE
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 1:6707 N RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:OH
Mailing Address - Zip Code:44057-2656
Mailing Address - Country:US
Mailing Address - Phone:440-428-3330
Mailing Address - Fax:440-428-3337
Practice Address - Street 1:6707 N RIDGE RD
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:OH
Practice Address - Zip Code:44057-2656
Practice Address - Country:US
Practice Address - Phone:440-428-3330
Practice Address - Fax:440-428-3337
Is Sole Proprietor?:No
Enumeration Date:2012-01-12
Last Update Date:2012-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03318748183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist