Healthcare Provider Details

I. General information

NPI: 1528333689
Provider Name (Legal Business Name): MARION DISCOUNT DRUGS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 02/17/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5332 DALE DRIVE
MARION MS
39342
US

IV. Provider business mailing address

5332 DALE DRIVE
MARION MS
39342
US

V. Phone/Fax

Practice location:
  • Phone: 601-485-2700
  • Fax: 601-485-2822
Mailing address:
  • Phone: 601-485-2700
  • Fax: 601-485-2822

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberE-08658
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number10563/1.1
License Number StateMS

VIII. Authorized Official

Name: MARCY TINGLE
Title or Position: PHARMACIST-IN-CHARGE
Credential: RPH
Phone: 601-485-2700