Provider Demographics
NPI:1285238493
Name:BOXX, KAREN EWING (PHARMACIST)
Entity type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:EWING
Last Name:BOXX
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:GRENADA
Mailing Address - State:MS
Mailing Address - Zip Code:38901-4063
Mailing Address - Country:US
Mailing Address - Phone:662-294-0665
Mailing Address - Fax:662-294-8826
Practice Address - Street 1:1209 SUNSET DR
Practice Address - Street 2:
Practice Address - City:GRENADA
Practice Address - State:MS
Practice Address - Zip Code:38901-4063
Practice Address - Country:US
Practice Address - Phone:662-294-0665
Practice Address - Fax:662-294-0886
Is Sole Proprietor?:No
Enumeration Date:2020-11-28
Last Update Date:2020-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-7191183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist