Provider Demographics
NPI:1861063224
Name:CARTER, ERIC ANDREW (PHARMD)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ANDREW
Last Name:CARTER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:146 QUAIL RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:JOHNSON CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37601-6313
Mailing Address - Country:US
Mailing Address - Phone:423-773-9810
Mailing Address - Fax:
Practice Address - Street 1:609 E ELK AVE
Practice Address - Street 2:
Practice Address - City:ELIZABETHTON
Practice Address - State:TN
Practice Address - Zip Code:37643-3329
Practice Address - Country:US
Practice Address - Phone:423-542-2138
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-07
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN45180OtherTN PHARMACIST LICENSE NUMBER