Provider Demographics
NPI:1982730933
Name:MARTIN, JOHARI JAMILLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JOHARI
Middle Name:JAMILLE
Last Name:MARTIN
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 1:6624 AVERELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45424-1850
Mailing Address - Country:US
Mailing Address - Phone:937-237-5687
Mailing Address - Fax:
Practice Address - Street 1:3875 SALEM AVE
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45406-1633
Practice Address - Country:US
Practice Address - Phone:937-277-1811
Practice Address - Fax:937-275-8893
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03-1-27223183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist