Basic Information
| Provider Information | |||||||||
| NPI: | 1366043242 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | GARLAND | ||||||||
| FirstName: | CHARNITA | ||||||||
| MiddleName: | JONES | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PHARM D | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5911 RICHMOND RD APT 6102 | ||||||||
| Address2: | |||||||||
| City: | TEXARKANA | ||||||||
| State: | TX | ||||||||
| PostalCode: | 755031205 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8704034507 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 109 MALONE DR | ||||||||
| Address2: | |||||||||
| City: | ARKADELPHIA | ||||||||
| State: | AR | ||||||||
| PostalCode: | 719238111 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8702465431 | ||||||||
| FaxNumber: | 8702465431 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/05/2020 | ||||||||
| LastUpdateDate: | 11/05/2020 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/05/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PD08538 | AR | Y | 193200000X MULTI-SPECIALTY GROUP | Pharmacy Service Providers | Pharmacist |
No ID Information.