Provider Demographics
NPI:1184835589
Name:GARRIS, CYNTHIA ELLENE (PHARM D)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:ELLENE
Last Name:GARRIS
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 MORNING VIEW DR
Mailing Address - Street 2:
Mailing Address - City:JONESBORO
Mailing Address - State:AR
Mailing Address - Zip Code:72404-8500
Mailing Address - Country:US
Mailing Address - Phone:870-972-4187
Mailing Address - Fax:879-972-6897
Practice Address - Street 1:ST, BERNARDS MEDIAL CENTER
Practice Address - Street 2:225 EAST JACKSON
Practice Address - City:JONESBORO
Practice Address - State:AR
Practice Address - Zip Code:72401
Practice Address - Country:US
Practice Address - Phone:870-972-4187
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR08547183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist