Healthcare Provider Details

I. General information

NPI: 1952378242
Provider Name (Legal Business Name): CAROL A MORREALE PHARMD, BCPS, CGP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2006
Last Update Date: 02/15/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 HIGHLAND PKWY DEPARTMENT OF PHARMACY
PICAYUNE MS
39466-5574
US

IV. Provider business mailing address

125 HUNTINGTON DR
HATTIESBURG MS
39402-8080
US

V. Phone/Fax

Practice location:
  • Phone: 601-358-9701
  • Fax:
Mailing address:
  • Phone: 304-382-3916
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberP11981
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: