Provider Demographics
NPI:1487257036
Name:JONES, CARA ELISE (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CARA
Middle Name:ELISE
Last Name:JONES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CARA
Other - Middle Name:JONES
Other - Last Name:DANTZLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1157 LAWHORN RD
Mailing Address - Street 2:
Mailing Address - City:BLYTHEWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29016-8981
Mailing Address - Country:US
Mailing Address - Phone:803-408-9589
Mailing Address - Fax:803-408-9854
Practice Address - Street 1:710 HIGHWAY 1 SOUTH
Practice Address - Street 2:
Practice Address - City:LUGOFF
Practice Address - State:SC
Practice Address - Zip Code:29078
Practice Address - Country:US
Practice Address - Phone:803-408-9589
Practice Address - Fax:803-408-9854
Is Sole Proprietor?:No
Enumeration Date:2020-11-17
Last Update Date:2020-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13499183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist