Provider Demographics
NPI:1063823979
Name:GLOVER, KARLA JONES (RPH)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:JONES
Last Name:GLOVER
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 1:4827 MISTY PINE LN
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-9541
Mailing Address - Country:US
Mailing Address - Phone:803-531-1586
Mailing Address - Fax:803-533-7300
Practice Address - Street 1:2795 NORTH RD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-2806
Practice Address - Country:US
Practice Address - Phone:803-531-1586
Practice Address - Fax:803-533-7300
Is Sole Proprietor?:Yes
Enumeration Date:2014-05-13
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC8246183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist