Provider Demographics
NPI:1407132947
Name:CASTEEL, ANGELINE AGNES (CPHT)
Entity Type:Individual
Prefix:
First Name:ANGELINE
Middle Name:AGNES
Last Name:CASTEEL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 WILL DR
Mailing Address - Street 2:
Mailing Address - City:WAYNESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:38485-4407
Mailing Address - Country:US
Mailing Address - Phone:931-332-6710
Mailing Address - Fax:931-722-9495
Practice Address - Street 1:215 DEXTER L WOODS MEMORIAL BLVD
Practice Address - Street 2:
Practice Address - City:WAYNESBORO
Practice Address - State:TN
Practice Address - Zip Code:38485-2416
Practice Address - Country:US
Practice Address - Phone:931-722-5466
Practice Address - Fax:931-722-9495
Is Sole Proprietor?:No
Enumeration Date:2011-10-28
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0000020357183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician