Healthcare Provider Details

I. General information

NPI: 1043498181
Provider Name (Legal Business Name): HULL'S PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/31/2008
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 24TH AVE
MERIDIAN MS
39301-3120
US

IV. Provider business mailing address

2000 24TH AVE
MERIDIAN MS
39301-3120
US

V. Phone/Fax

Practice location:
  • Phone: 601-693-0033
  • Fax:
Mailing address:
  • Phone:
  • Fax: 601-693-0062

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number03424
License Number StateMS
# 2
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number03424
License Number StateMS

VIII. Authorized Official

Name: MR. LESLIE C HULL
Title or Position: PHARMACIST OWNER
Credential: RPH
Phone: 601-693-0033