Healthcare Provider Details

I. General information

NPI: 1073577342
Provider Name (Legal Business Name): JOLYN LANGFORD GARCIA PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 CARLTON RD
PALMETTO GA
30268-1052
US

IV. Provider business mailing address

240 BRITTAIN WAY
NEWNAN GA
30263-6939
US

V. Phone/Fax

Practice location:
  • Phone: 770-463-4031
  • Fax: 770-463-4946
Mailing address:
  • Phone: 770-683-8099
  • Fax: 770-463-4946

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH020440
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: