Provider Demographics
NPI:1407124514
Name:ST. LOUIS, KAROL SCOTT (RPH)
Entity Type:Individual
Prefix:
First Name:KAROL
Middle Name:SCOTT
Last Name:ST. LOUIS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6130 HIGHWAY 49
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39401-7300
Mailing Address - Country:US
Mailing Address - Phone:601-545-6959
Mailing Address - Fax:601-545-6964
Practice Address - Street 1:6130 HIGHWAY 49
Practice Address - Street 2:
Practice Address - City:HATTIESBURG
Practice Address - State:MS
Practice Address - Zip Code:39401-7300
Practice Address - Country:US
Practice Address - Phone:601-545-6959
Practice Address - Fax:601-545-6964
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-03
Last Update Date:2011-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-08234183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MSE-08234OtherMS STATE BOARD OF PHARMACY