Provider Demographics
NPI:1144820101
Name:CARICO, KELLY HILL (PHARMD)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:HILL
Last Name:CARICO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:142 SUNRISE LN
Mailing Address - Street 2:
Mailing Address - City:FRIES
Mailing Address - State:VA
Mailing Address - Zip Code:24330-4401
Mailing Address - Country:US
Mailing Address - Phone:276-236-7118
Mailing Address - Fax:276-236-3047
Practice Address - Street 1:1140 E STUART DR
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-2630
Practice Address - Country:US
Practice Address - Phone:276-236-7118
Practice Address - Fax:276-236-3047
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210675183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist