Provider Demographics
NPI:1942608278
Name:PATE, ASHLEY (PHARM D)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:PATE
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6270 BAINS RD
Mailing Address - Street 2:
Mailing Address - City:ETHELSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35461-2506
Mailing Address - Country:US
Mailing Address - Phone:662-630-0882
Mailing Address - Fax:
Practice Address - Street 1:201B ALABAMA ST
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-5203
Practice Address - Country:US
Practice Address - Phone:662-327-0900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-19
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-13828183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist