Provider Demographics
NPI:1205134251
Name:MILES, DEANA JONES (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEANA
Middle Name:JONES
Last Name:MILES
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DEANA
Other - Middle Name:MARIE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1537 CHARLESTON HWY
Mailing Address - Street 2:
Mailing Address - City:WEST COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29169-5047
Mailing Address - Country:US
Mailing Address - Phone:803-796-3392
Mailing Address - Fax:803-796-9628
Practice Address - Street 1:1537 CHARLESTON HWY
Practice Address - Street 2:
Practice Address - City:WEST COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29169-5047
Practice Address - Country:US
Practice Address - Phone:803-796-3392
Practice Address - Fax:803-796-9628
Is Sole Proprietor?:No
Enumeration Date:2011-02-28
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12192183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist