Healthcare Provider Details

I. General information

NPI: 1710803424
Provider Name (Legal Business Name): MARTIN SWOOPE ENTERPRISES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40518 OLD HIGHWAY 45 S
HAMILTON MS
39746-9799
US

IV. Provider business mailing address

40518 OLD HIGHWAY 45 S
HAMILTON MS
39746-9799
US

V. Phone/Fax

Practice location:
  • Phone: 662-362-7070
  • Fax: 662-362-7249
Mailing address:
  • Phone: 662-362-7070
  • Fax: 662-362-7249

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: HOLLY REEVES
Title or Position: PHARMACIST IN CHARGE/OWNER
Credential: R.PH.
Phone: 662-319-7946