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General NPI Number Information
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NPI Number | 1982730933
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Entity Type | Individual
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Provider Name | JOHARI JAMILLE MARTIN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 3875 SALEM AVE
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City | DAYTON
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State | OH
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Zip | 45406-1633
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Country | US
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Telephone | 937-277-1811
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Fax | 937-275-8893
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Provider Business Mailing Address
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Address Line | 6624 AVERELL DRIVE
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City | DAYTON
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State | OH
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Zip | 45424-1850
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Country | US
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Telephone | 937-237-5687
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 03-1-27223
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License Number State | OH
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