Provider Demographics
NPI:1326830191
Name:ANDERSON, CAROLE (RPH)
Entity type:Individual
Prefix:
First Name:CAROLE
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:
Other - Last Name:GOEHRING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 86
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:SD
Mailing Address - Zip Code:57201-0086
Mailing Address - Country:US
Mailing Address - Phone:605-881-9673
Mailing Address - Fax:605-753-9012
Practice Address - Street 1:15027 473RD AVE
Practice Address - Street 2:
Practice Address - City:TWIN BROOKS
Practice Address - State:SD
Practice Address - Zip Code:57269-5823
Practice Address - Country:US
Practice Address - Phone:605-881-9673
Practice Address - Fax:605-881-9673
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-19
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SD4772183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist