Healthcare Provider Details

I. General information

NPI: 1144874868
Provider Name (Legal Business Name): WHITNEY HARRIS DRUGS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/31/2019
Last Update Date: 07/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 EASTOVER DR STE 175
JACKSON MS
39211-6317
US

IV. Provider business mailing address

PO BOX 16360
JACKSON MS
39236-6360
US

V. Phone/Fax

Practice location:
  • Phone: 601-953-3368
  • Fax:
Mailing address:
  • Phone: 601-953-3368
  • Fax:

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: ANDREA WHITNEY HARRIS
Title or Position: PIC/OWNER
Credential:
Phone: 601-953-3368