Provider Demographics
NPI:1578841847
Name:STRINGFELLOW, TARA (RPH)
Entity Type:Individual
Prefix:
First Name:TARA
Middle Name:
Last Name:STRINGFELLOW
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 1:3188 WARD PINEVIEW RD
Mailing Address - Street 2:
Mailing Address - City:LUCEDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39452-6213
Mailing Address - Country:US
Mailing Address - Phone:601-766-3007
Mailing Address - Fax:
Practice Address - Street 1:103 W FRONTAGE RD
Practice Address - Street 2:SUITE A
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-5836
Practice Address - Country:US
Practice Address - Phone:601-947-4941
Practice Address - Fax:601-766-3010
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2011-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MST09505183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist