Basic Information
| Provider Information | |||||||||
| NPI: | 1194742197 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | CASTEEL | ||||||||
| FirstName: | LAURA | ||||||||
| MiddleName: | F | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | PHARM.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 183 COUNTY ROAD 721 | ||||||||
| Address2: | |||||||||
| City: | RICEVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373705372 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4234622810 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1805 INGLESIDE AVE | ||||||||
| Address2: | |||||||||
| City: | ATHENS | ||||||||
| State: | TN | ||||||||
| PostalCode: | 373032105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4237453367 | ||||||||
| FaxNumber: | 4237453368 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/16/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | 10782 | TN | Y | Pharmacy Service Providers | Pharmacist | 183500000X | RPH021554 | GA | N | Pharmacy Service Providers | Pharmacist |
No ID Information.