Provider Demographics
NPI:1366208696
Name:GARLAND, JIMMY RAY II (PHARMD)
Entity type:Individual
Prefix:
First Name:JIMMY
Middle Name:RAY
Last Name:GARLAND
Suffix:II
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:416 DOGWOOD TRCE
Mailing Address - Street 2:
Mailing Address - City:CORBIN
Mailing Address - State:KY
Mailing Address - Zip Code:40701-6277
Mailing Address - Country:US
Mailing Address - Phone:606-304-5747
Mailing Address - Fax:
Practice Address - Street 1:60 S STEWART RD
Practice Address - Street 2:
Practice Address - City:CORBIN
Practice Address - State:KY
Practice Address - Zip Code:40701-4675
Practice Address - Country:US
Practice Address - Phone:606-523-2206
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-02-23
Last Update Date:2024-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY023217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist