Marquitta Bolden, PHARM D.
Individual provider Active NPI Pharmacist · Ridgeland, MS
NPI 1699375295 · NPPES record last updated Nov 1, 2020
Key facts
- NPI
- 1699375295
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- E-09230 (MS)
- Practice address
- 815 S Wheatley St
Ridgeland, MS 39157-5002 - Phone
- (601) 956-1466
- Fax
- (601) 957-1603
- NPI assigned
- Nov 1, 2020
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-09230 | MS | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-09230 | MS | Yes |
Addresses
Primary practice location
815 S Wheatley St
Ridgeland, MS 39157-5002
Mailing address
152 Rollingwood Dr
Jackson, MS 39211-4716
Phone (601) 955-2278
Other providers in Ridgeland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 1, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.