Provider Demographics
NPI:1548858186
Name:MACH, CARRIE LYNN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:LYNN
Last Name:MACH
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 1:746 SHADOW BAY WAY
Mailing Address - Street 2:
Mailing Address - City:OSPREY
Mailing Address - State:FL
Mailing Address - Zip Code:34229-8872
Mailing Address - Country:US
Mailing Address - Phone:612-481-1279
Mailing Address - Fax:
Practice Address - Street 1:746 SHADOW BAY WAY
Practice Address - Street 2:
Practice Address - City:OSPREY
Practice Address - State:FL
Practice Address - Zip Code:34229-8872
Practice Address - Country:US
Practice Address - Phone:612-481-1279
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-08
Last Update Date:2021-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL61775183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist