Provider Demographics
NPI:1124379813
Name:TOLIA, JALLIKA (RPH)
Entity Type:Individual
Prefix:MRS
First Name:JALLIKA
Middle Name:
Last Name:TOLIA
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 1:8540 SCHOLARS LN
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20723-2018
Mailing Address - Country:US
Mailing Address - Phone:240-568-8540
Mailing Address - Fax:815-550-9676
Practice Address - Street 1:8540 SCHOLARS LN
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MD
Practice Address - Zip Code:20723-2018
Practice Address - Country:US
Practice Address - Phone:240-568-8540
Practice Address - Fax:815-550-9676
Is Sole Proprietor?:No
Enumeration Date:2012-09-21
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARP040532L183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist