Healthcare Provider Details

I. General information

NPI: 1770519357
Provider Name (Legal Business Name): FLORA DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2006
Last Update Date: 09/06/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

740 HIGHWAY 49 N SUITE U
FLORA MS
39071-9347
US

IV. Provider business mailing address

740 HIGHWAY 49 N SUITE U
FLORA MS
39071-9347
US

V. Phone/Fax

Practice location:
  • Phone: 601-879-9100
  • Fax: 601-879-8108
Mailing address:
  • Phone: 601-879-9100
  • Fax: 601-879-8108

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number05959/01.1
License Number StateMS

VIII. Authorized Official

Name: MR. BILLY CLAY CLANTON JR.
Title or Position: PRESIDENT
Credential: R.PH.
Phone: 601-879-9100