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DR. JOSE M CARRASCO PHARM.D.
>> Pharmacist >> Pharmacy Service ProvidersRegistrant NPI Number: 1215286752
Individual Registrant:DR. JOSE M CARRASCO PHARM.D.
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
4016 TOWNE LAKES CIR APT #7212 GRAND CHUTE, WI 54913-8006 US
Tel: 708-990-9202 Fax: --
Tel: 708-990-9202 Fax: --
Contact information for business:
4016 TOWNE LAKES CIR APT #7212 GRAND CHUTE, WI 54913-8006 US
Tel: 708-990-9202 Fax: --
Tel: 708-990-9202 Fax: --
Registration Information:
NPI: 1215286752
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 183500000X | Pharmacy Service Providers Pharmacist | WI | 16879-40 |
| N | 183500000X | Pharmacy Service Providers Pharmacist | IL | 051296162 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
