Provider Demographics
NPI:1982766424
Name:SINGLETARY, CHARLENE HANSEN (RPH CPH)
Entity Type:Individual
Prefix:
First Name:CHARLENE
Middle Name:HANSEN
Last Name:SINGLETARY
Suffix:
Gender:F
Credentials:RPH CPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4463 BARNABY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32217-9334
Mailing Address - Country:US
Mailing Address - Phone:850-567-1296
Mailing Address - Fax:
Practice Address - Street 1:4463 BARNABY DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32217-9334
Practice Address - Country:US
Practice Address - Phone:850-567-1296
Practice Address - Fax:904-636-7792
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2012-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS 16641183500000X
FLPU 50971835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835G0303XPharmacy Service ProvidersPharmacistGeriatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA12455OtherREGISTERED PHARMACIST
FLPU 5097OtherCONSULTANT PHARMACIST
AL9241OtherREGISTERED PHARMACIST
FLPS 16641OtherREGISTERED PHARMACIST