Provider Demographics
NPI:1245670710
Name:MARRONGELLI, CHRISTINA G (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:G
Last Name:MARRONGELLI
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 1:28361 HIGHWAY 35
Mailing Address - Street 2:
Mailing Address - City:SARDIS
Mailing Address - State:MS
Mailing Address - Zip Code:38666-5528
Mailing Address - Country:US
Mailing Address - Phone:662-703-9413
Mailing Address - Fax:
Practice Address - Street 1:28361 HIGHWAY 35
Practice Address - Street 2:
Practice Address - City:SARDIS
Practice Address - State:MS
Practice Address - Zip Code:38666-5528
Practice Address - Country:US
Practice Address - Phone:662-703-9413
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-28
Last Update Date:2013-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist