Provider Demographics
NPI:1225346489
Name:SLOAN, REBECCA MCDOLE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:MCDOLE
Last Name:SLOAN
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 1:3341 HALLS FERRY RD.
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39183
Mailing Address - Country:US
Mailing Address - Phone:601-661-9340
Mailing Address - Fax:
Practice Address - Street 1:3341 HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-5338
Practice Address - Country:US
Practice Address - Phone:601-661-9340
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-21
Last Update Date:2010-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010552183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist