Provider Demographics
NPI:1396352266
Name:GREEN, JAMILAH E (PHARMD)
Entity type:Individual
Prefix:DR
First Name:JAMILAH
Middle Name:E
Last Name:GREEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:JAMILAH
Other - Middle Name:E
Other - Last Name:CHADWICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3013 OCONEE LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28213-4077
Mailing Address - Country:US
Mailing Address - Phone:984-232-4193
Mailing Address - Fax:
Practice Address - Street 1:3013 OCONEE LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28213-4077
Practice Address - Country:US
Practice Address - Phone:984-232-4193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-25
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC191911835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8988301OtherDL