Provider Demographics
NPI:1528377579
Name:HARTSFIELD, VALERIE (RPH)
Entity Type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:HARTSFIELD
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 1:236 DESOTO AVE
Mailing Address - Street 2:
Mailing Address - City:CLARKSDALE
Mailing Address - State:MS
Mailing Address - Zip Code:38614-4422
Mailing Address - Country:US
Mailing Address - Phone:662-624-5456
Mailing Address - Fax:662-624-6416
Practice Address - Street 1:236 DESOTO AVE
Practice Address - Street 2:
Practice Address - City:CLARKSDALE
Practice Address - State:MS
Practice Address - Zip Code:38614-4422
Practice Address - Country:US
Practice Address - Phone:662-624-5456
Practice Address - Fax:662-624-6416
Is Sole Proprietor?:No
Enumeration Date:2010-09-24
Last Update Date:2010-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-07796183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist