Provider Demographics
NPI:1134429681
Name:CARNAHAN, DOUG HARLEY (PHARMCIST)
Entity type:Individual
Prefix:MR
First Name:DOUG
Middle Name:HARLEY
Last Name:CARNAHAN
Suffix:
Gender:M
Credentials:PHARMCIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4733 E PALM CANYON DR
Mailing Address - Street 2:
Mailing Address - City:PALM SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92264-5219
Mailing Address - Country:US
Mailing Address - Phone:760-324-8269
Mailing Address - Fax:760-202-3432
Practice Address - Street 1:4733 E PALM CANYON DR
Practice Address - Street 2:
Practice Address - City:PALM SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92264-5219
Practice Address - Country:US
Practice Address - Phone:760-324-8269
Practice Address - Fax:760-202-3432
Is Sole Proprietor?:No
Enumeration Date:2010-11-01
Last Update Date:2010-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54434183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist