Provider Demographics
NPI:1730998642
Name:READ, MARY BLAIR (RPH)
Entity type:Individual
Prefix:MRS
First Name:MARY
Middle Name:BLAIR
Last Name:READ
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WANSLEY RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MS
Mailing Address - Zip Code:39440-3235
Mailing Address - Country:US
Mailing Address - Phone:601-422-9007
Mailing Address - Fax:
Practice Address - Street 1:1107 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:LAUREL
Practice Address - State:MS
Practice Address - Zip Code:39440-4352
Practice Address - Country:US
Practice Address - Phone:601-682-0494
Practice Address - Fax:601-682-0493
Is Sole Proprietor?:No
Enumeration Date:2025-01-06
Last Update Date:2025-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-07913183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist