Healthcare Provider Details

I. General information

NPI: 1770579419
Provider Name (Legal Business Name): MARJORIE J HOWARD PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/27/2005
Last Update Date: 03/29/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 LAKESHORE PT
SAINT MARYS GA
31558-3843
US

IV. Provider business mailing address

1650 ISLES OF ST MARYS WAY
SAINT MARYS GA
31558-4208
US

V. Phone/Fax

Practice location:
  • Phone: 912-510-3420
  • Fax: 912-510-3429
Mailing address:
  • Phone: 941-276-3761
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS37104
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: