Provider Demographics
NPI:1053569939
Name:COURCOUX, CAROLE ALEXANDRA (RPH)
Entity type:Individual
Prefix:MISS
First Name:CAROLE
Middle Name:ALEXANDRA
Last Name:COURCOUX
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:228 JAMISON DR
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27610-8618
Mailing Address - Country:US
Mailing Address - Phone:919-946-4953
Mailing Address - Fax:
Practice Address - Street 1:2311 TIMBER DR
Practice Address - Street 2:
Practice Address - City:GARNER
Practice Address - State:NC
Practice Address - Zip Code:27529-2586
Practice Address - Country:US
Practice Address - Phone:919-661-7799
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC19061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist