Provider Demographics
NPI:1891975207
Name:MARET, CHARLES DAVID (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:DAVID
Last Name:MARET
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:128 HUNTINGTON RD
Mailing Address - Street 2:
Mailing Address - City:DALTON
Mailing Address - State:GA
Mailing Address - Zip Code:30720-3854
Mailing Address - Country:US
Mailing Address - Phone:706-278-0100
Mailing Address - Fax:706-259-3291
Practice Address - Street 1:128 HUNTINGTON RD
Practice Address - Street 2:
Practice Address - City:DALTON
Practice Address - State:GA
Practice Address - Zip Code:30720-3854
Practice Address - Country:US
Practice Address - Phone:706-278-0100
Practice Address - Fax:706-259-3291
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA8714183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist