Provider Demographics
NPI:1548086754
Name:JUNE, CARL
Entity type:Individual
Prefix:
First Name:CARL
Middle Name:
Last Name:JUNE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30732 MOLLY B RD
Mailing Address - Street 2:
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-3854
Mailing Address - Country:US
Mailing Address - Phone:302-382-0540
Mailing Address - Fax:
Practice Address - Street 1:30214 SUSSEX HWY UNIT 7
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:DE
Practice Address - Zip Code:19956-3880
Practice Address - Country:US
Practice Address - Phone:302-875-5400
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-03
Last Update Date:2024-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEA10001539183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist