MEDICARE: DUTCH PHARMACIES INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	333600000X	Pharmacy
2	3336C0003X	Community/Retail Pharmacy	02021/02.2	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	2117264	OTHER		PK

General Provider Information

NPI Number	:	1679724082
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DUTCH PHARMACIES INC

Provider Business Mailing Address
First Line	:	3654 NEW HOPE RD
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-8521
Country	:	US
Telephone Number	:	662-328-8028
Fax Number	:	662-328-3149

Provider Business Practice Location Address
First Line	:	3654 NEW HOPE RD
Second Line	:
City	:	COLUMBUS
State	:	MS
Zip	:	39702-8521
Country	:	US
Telephone Number	:	662-328-8028
Fax Number	:	662-328-3149

Authorized Official
Title or Position	:	OWNER
Name	:	JOSEPH GILLIS
Credential	:
Telephone Number	:	662-327-5202

Provider Enumeration Date	:	10/03/2008
Last Update Date	:	06/10/2025

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Directions to “DUTCH PHARMACIES INC ” Practice Location

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