Provider Demographics
NPI:1023400512
Name:ROYALS, JANET BERNICE (MS, PHARMD)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:BERNICE
Last Name:ROYALS
Suffix:
Gender:F
Credentials:MS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3833 THAXTON RD SW
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30331-7978
Mailing Address - Country:US
Mailing Address - Phone:404-565-3583
Mailing Address - Fax:
Practice Address - Street 1:6239 TURNER LAKE RD NW
Practice Address - Street 2:
Practice Address - City:COVINGTON
Practice Address - State:GA
Practice Address - Zip Code:30014-2064
Practice Address - Country:US
Practice Address - Phone:770-787-7877
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-02-20
Last Update Date:2015-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH028257183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist