Provider Demographics
NPI:1972045086
Name:GREENWAY, ASHLEY (RPH)
Entity Type:Individual
Prefix:MRS
First Name:ASHLEY
Middle Name:
Last Name:GREENWAY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MS
Other - First Name:ASHLEY
Other - Middle Name:MILLER
Other - Last Name:GREENWAY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RPH
Mailing Address - Street 1:2205 14TH ST
Mailing Address - Street 2:
Mailing Address - City:MERIDIAN
Mailing Address - State:MS
Mailing Address - Zip Code:39301-4043
Mailing Address - Country:US
Mailing Address - Phone:601-693-1978
Mailing Address - Fax:601-693-4417
Practice Address - Street 1:2205 14TH ST
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:MS
Practice Address - Zip Code:39301-4043
Practice Address - Country:US
Practice Address - Phone:601-693-1978
Practice Address - Fax:601-693-4417
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-07
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-7366183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E-7366OtherMS STATE BOARD OF PHARMACY