Provider Demographics
NPI:1033490610
Name:GARISH, DANA LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:DANA
Middle Name:LYNN
Last Name:GARISH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17317 COVE VIEW CT
Mailing Address - Street 2:
Mailing Address - City:CORNELIUS
Mailing Address - State:NC
Mailing Address - Zip Code:28031-7758
Mailing Address - Country:US
Mailing Address - Phone:317-294-6172
Mailing Address - Fax:
Practice Address - Street 1:7920 SAM FURR RD
Practice Address - Street 2:
Practice Address - City:HUNTERSVILLE
Practice Address - State:NC
Practice Address - Zip Code:28078-8911
Practice Address - Country:US
Practice Address - Phone:704-896-3671
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-08
Last Update Date:2011-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC20012183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist