Provider Demographics
NPI:1013290667
Name:WEST, JAWANDA LYNETTE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JAWANDA
Middle Name:LYNETTE
Last Name:WEST
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 1:634 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:THOMASTON
Mailing Address - State:GA
Mailing Address - Zip Code:30286-3612
Mailing Address - Country:US
Mailing Address - Phone:706-647-4000
Mailing Address - Fax:706-647-4020
Practice Address - Street 1:634 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:THOMASTON
Practice Address - State:GA
Practice Address - Zip Code:30286-3612
Practice Address - Country:US
Practice Address - Phone:706-647-4000
Practice Address - Fax:706-647-4020
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH024140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist