Healthcare Provider Details

I. General information

NPI: 1326042888
Provider Name (Legal Business Name): COLUMBIA DISCOUNT DRUGS, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2005
Last Update Date: 09/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1201 HIGHWAY 13 N
COLUMBIA MS
39429-2015
US

IV. Provider business mailing address

1201 HIGHWAY 13 N
COLUMBIA MS
39429-2015
US

V. Phone/Fax

Practice location:
  • Phone: 601-736-1514
  • Fax: 601-736-1514
Mailing address:
  • Phone: 601-736-1514
  • Fax: 601-736-1514

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number01046/1.1
License Number StateMS

VIII. Authorized Official

Name: DARREN HIGGS
Title or Position: PRESIDENT
Credential:
Phone: 601-736-1514