Individual
MRS. CHARLOTTE DENISE TIVEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
719 S HIGHWAY 19, PALATKA, FL 32177-3946
(386) 328-6787
(386) 328-8641
Mailing address
719 S HIGHWAY 19, PALATKA, FL 32177-3946
(386) 328-6787
(386) 328-8641
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS25587
FL
183500000X
Pharmacist
RPH016165
GA
Other
Enumeration date
08/29/2011
Last updated
08/29/2011
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