Healthcare Provider Details

I. General information

NPI: 1336534916
Provider Name (Legal Business Name): OPUS RX, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/01/2015
Last Update Date: 04/01/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

350 W WOODROW WILSON AVE STE 311
JACKSON MS
39213-7681
US

IV. Provider business mailing address

350 W WOODROW WILSON AVE STE 311
JACKSON MS
39213-7681
US

V. Phone/Fax

Practice location:
  • Phone: 601-326-5378
  • Fax:
Mailing address:
  • Phone: 601-326-5378
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number14158
License Number StateMS

VIII. Authorized Official

Name: KARIE BOYD
Title or Position: PHARMACY MANAGER
Credential:
Phone: 601-326-5378