Healthcare Provider Details

I. General information

NPI: 1922134329
Provider Name (Legal Business Name): HOUSTON DISCOUNT DRUGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2007
Last Update Date: 02/17/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 E MAIN ST
BALDWYN MS
38824-1813
US

IV. Provider business mailing address

110 E MAIN ST
BALDWYN MS
38824-1813
US

V. Phone/Fax

Practice location:
  • Phone: 662-365-8261
  • Fax: 662-365-2343
Mailing address:
  • Phone: 662-365-8261
  • Fax: 662-365-2343

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number00236011
License Number StateMS

VIII. Authorized Official

Name: JOESPH COLLINS
Title or Position: VP
Credential: RPH
Phone: 662-365-8261