Provider Demographics
NPI:1891072484
Name:STRAIN, OLIVIA (PHARMD)
Entity Type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:STRAIN
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 1:105 ST REGIS DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:MS
Mailing Address - Zip Code:39110-7939
Mailing Address - Country:US
Mailing Address - Phone:601-956-3844
Mailing Address - Fax:601-956-5493
Practice Address - Street 1:6970 OLD CANTON RD
Practice Address - Street 2:
Practice Address - City:RIDGELAND
Practice Address - State:MS
Practice Address - Zip Code:39157-1229
Practice Address - Country:US
Practice Address - Phone:601-956-3844
Practice Address - Fax:601-956-5493
Is Sole Proprietor?:No
Enumeration Date:2011-11-09
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010238183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist