Healthcare Provider Details

I. General information

NPI: 1346394442
Provider Name (Legal Business Name): HODGES PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 02/29/2024
Certification Date: 02/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

411 SAINT FRANCIS ST
LEAKESVILLE MS
39451-8909
US

IV. Provider business mailing address

PO BOX 699
LEAKESVILLE MS
39451-0699
US

V. Phone/Fax

Practice location:
  • Phone: 601-394-2602
  • Fax: 601-394-5501
Mailing address:
  • Phone: 601-394-2602
  • Fax: 601-394-5501

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number00153
License Number StateMS

VIII. Authorized Official

Name: FRANKLIN WAYNE HODGES JR.
Title or Position: OWNER
Credential:
Phone: 601-394-2602