Provider Demographics
NPI:1376115030
Name:TOLES, LANAESHA COX (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:LANAESHA
Middle Name:COX
Last Name:TOLES
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 1:104 COUNTY ROAD 550
Mailing Address - Street 2:
Mailing Address - City:WATER VALLEY
Mailing Address - State:MS
Mailing Address - Zip Code:38965-3484
Mailing Address - Country:US
Mailing Address - Phone:662-587-1344
Mailing Address - Fax:
Practice Address - Street 1:303 MEDICAL CENTER DR STE 101
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-8608
Practice Address - Country:US
Practice Address - Phone:662-712-1478
Practice Address - Fax:662-712-1479
Is Sole Proprietor?:No
Enumeration Date:2021-07-13
Last Update Date:2021-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-14944183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist