Provider Demographics
NPI:1164495990
Name:BABB, CARLA N (CPHT)
Entity type:Individual
Prefix:MRS
First Name:CARLA
Middle Name:N
Last Name:BABB
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 284
Mailing Address - Street 2:
Mailing Address - City:WINFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37892-0284
Mailing Address - Country:US
Mailing Address - Phone:423-223-5994
Mailing Address - Fax:
Practice Address - Street 1:18157 ALBERTA ST
Practice Address - Street 2:
Practice Address - City:ONEIDA
Practice Address - State:TN
Practice Address - Zip Code:37841-6201
Practice Address - Country:US
Practice Address - Phone:423-569-5211
Practice Address - Fax:423-569-8805
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN16891183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician