Active NPI
Brenda Denise Carlile, RPH
- Pharmacist
- Roswell, NM
National Provider Identifier
1104461862
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- RP00005850
- Practice address
- 4500 N Main St
Roswell, NM 88201-0305 - Phone
- (575) 624-2904
- NPI assigned
- Nov 16, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | RP00005850 | NM | Primary |
Addresses
Primary practice location
4500 N Main St
Roswell, NM 88201-0305
Mailing address
42151 Little River Rd
Tecumseh, OK 74873-7576
Phone (719) 369-3022
Other practice location 1
196 Shawnee Mall Dr
Shawnee, OK 74804-1337
Phone (405) 878-0821
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RP00005850 | NM | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1573862400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1573862400000",
"number": "1104461862",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "42151 LITTLE RIVER RD",
"city": "TECUMSEH",
"state": "OK",
"postal_code": "748737576",
"telephone_number": "719-369-3022"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4500 N MAIN ST",
"city": "ROSWELL",
"state": "NM",
"postal_code": "882010305",
"telephone_number": "575-624-2904"
}
],
"practiceLocations": [
{
"address_1": "196 Shawnee Mall Dr",
"address_purpose": "LOCATION",
"city": "Shawnee",
"state": "OK",
"postal_code": "748041337",
"country_code": "US",
"telephone_number": "405-878-0821",
"fax_number": "405-878-0174",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "CARLILE",
"first_name": "BRENDA",
"middle_name": "DENISE",
"name_prefix": "Mrs.",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-11-16",
"last_updated": "2019-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "NM",
"license": "RP00005850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.