Travis Robert Carlson
Individual provider Active NPI Pharmacist · Epping, NH
NPI 1689392128 · NPPES record last updated Aug 19, 2022
Key facts
- NPI
- 1689392128
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PHCY-01386 (NH)
- Practice address
- 12 Main St
Epping, NH 03042-2425 - Phone
- (603) 679-5839
- NPI assigned
- Aug 19, 2022
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PHCY-01386 | NH | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
12 Main St
Epping, NH 03042
Phone (603) 679-5839
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHCY-01386 | NH | Yes |
Addresses
Primary practice location
12 Main St
Epping, NH 03042-2425
Mailing address
140 Lords Mill Rd
Epsom, NH 03234-4917
Phone (603) 738-3440
Other providers in Epping, NH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.