Healthcare Provider Details

I. General information

NPI: 1174951610
Provider Name (Legal Business Name): JENNA GARLOCK PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/18/2013
Last Update Date: 03/17/2021
Certification Date: 03/17/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 AKRON GENERAL AVE.
AKRON OH
44307
US

IV. Provider business mailing address

8000 VANDERBILT DR NW
NORTH CANTON OH
44720-5760
US

V. Phone/Fax

Practice location:
  • Phone: 330-344-3904
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number03131799
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: