Provider Demographics
NPI:1619259439
Name:MILLS, CHARELL (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:CHARELL
Middle Name:
Last Name:MILLS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 S HOLIDAY DR
Mailing Address - Street 2:
Mailing Address - City:SLIDELL
Mailing Address - State:LA
Mailing Address - Zip Code:70461-5409
Mailing Address - Country:US
Mailing Address - Phone:504-723-6776
Mailing Address - Fax:
Practice Address - Street 1:835 PRIDE DR STE B-75
Practice Address - Street 2:
Practice Address - City:HAMMOND
Practice Address - State:LA
Practice Address - Zip Code:70401-9527
Practice Address - Country:US
Practice Address - Phone:985-277-1440
Practice Address - Fax:985-277-9085
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-16
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA18859183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist