Provider Demographics
NPI:1922317197
Name:STRINGER, MARTHA ANN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:MARTHA
Middle Name:ANN
Last Name:STRINGER
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:PO BOX 1106
Mailing Address - Street 2:
Mailing Address - City:PRENTISS
Mailing Address - State:MS
Mailing Address - Zip Code:39474-1106
Mailing Address - Country:US
Mailing Address - Phone:601-792-5145
Mailing Address - Fax:601-792-8287
Practice Address - Street 1:1635 COLUMBIA AVE.
Practice Address - Street 2:
Practice Address - City:PRENTISS
Practice Address - State:MS
Practice Address - Zip Code:39474
Practice Address - Country:US
Practice Address - Phone:601-792-5145
Practice Address - Fax:601-792-8287
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-05
Last Update Date:2010-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE5519183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist