Provider Demographics
NPI:1851976146
Name:GARSIDE, JANICE ELLIS (PHARMD)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:ELLIS
Last Name:GARSIDE
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 1:3712 WILLIAMSBOROUGH CT
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-6358
Mailing Address - Country:US
Mailing Address - Phone:919-649-7457
Mailing Address - Fax:
Practice Address - Street 1:3712 WILLIAMSBOROUGH CT
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27609-6358
Practice Address - Country:US
Practice Address - Phone:919-649-7457
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-17
Last Update Date:2021-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC12139183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty