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Individual

MR. JERMEL E GOLSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6510 COLUMBIA AVE, HAMMOND, IN 46320-2748
(219) 931-3332
(219) 852-9201
Mailing address
3675 VIRGINIA ST, GARY, IN 46409-1354
(219) 742-0064

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26023408A
IN

Other

Enumeration date
01/04/2012
Last updated
01/04/2012
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