Provider Demographics
NPI:1043347503
Name:MORTON, MARI-RUTH E (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:MARI-RUTH
Middle Name:E
Last Name:MORTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1410 N BROAD ST
Mailing Address - Street 2:
Mailing Address - City:TAZEWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37879
Mailing Address - Country:US
Mailing Address - Phone:423-626-2344
Mailing Address - Fax:423-626-2877
Practice Address - Street 1:1410 N BROAD ST
Practice Address - Street 2:
Practice Address - City:TAZEWELL
Practice Address - State:TN
Practice Address - Zip Code:37879
Practice Address - Country:US
Practice Address - Phone:423-626-2344
Practice Address - Fax:423-626-2877
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2021-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN11512183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist