Provider Demographics
NPI:1952378242
Name:MORREALE, CAROL A (PHARMD, BCPS, CGP)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:A
Last Name:MORREALE
Suffix:
Gender:F
Credentials:PHARMD, BCPS, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 HUNTINGTON DR
Mailing Address - Street 2:
Mailing Address - City:HATTIESBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39402-8080
Mailing Address - Country:US
Mailing Address - Phone:304-382-3916
Mailing Address - Fax:
Practice Address - Street 1:130 HIGHLAND PKWY
Practice Address - Street 2:DEPARTMENT OF PHARMACY
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-5574
Practice Address - Country:US
Practice Address - Phone:601-358-9701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-05
Last Update Date:2013-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSP119811835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist