Healthcare Provider Details

I. General information

NPI: 1588304380
Provider Name (Legal Business Name): FLOWOOD DRUG COMPANY, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/30/2022
Certification Date: 03/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

281 BELLE MEADE PT STE B
FLOWOOD MS
39232-3311
US

IV. Provider business mailing address

281 BELLE MEADE PT STE B
FLOWOOD MS
39232-3311
US

V. Phone/Fax

Practice location:
  • Phone: 601-506-5137
  • Fax:
Mailing address:
  • Phone: 601-506-5137
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0004X
TaxonomyCompounding Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: TIFFANY HUTCHINS
Title or Position: OWNER
Credential: PHARM. D
Phone: 601-506-5137