Healthcare Provider Details

I. General information

NPI: 1346161296
Provider Name (Legal Business Name): MPOH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1425 S HARPER RD
CORINTH MS
38834-6613
US

IV. Provider business mailing address

1425 S HARPER RD
CORINTH MS
38834-6613
US

V. Phone/Fax

Practice location:
  • Phone: 662-286-6337
  • Fax: 662-396-6333
Mailing address:
  • Phone: 662-286-6337
  • Fax: 662-396-6333

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: J BART DORAN
Title or Position: OWNER
Credential: PHARMD
Phone: 662-415-3498