Healthcare Provider Details

I. General information

NPI: 1649497744
Provider Name (Legal Business Name): HOSPITAL DISCOUNT PHARMACY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 02/20/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

919 HOLLAND AVE
PHILADELPHIA MS
39350-2115
US

IV. Provider business mailing address

PO BOX 870
PHILADELPHIA MS
39350-0870
US

V. Phone/Fax

Practice location:
  • Phone: 601-656-2621
  • Fax: 601-656-2623
Mailing address:
  • Phone: 601-656-2621
  • Fax: 601-656-2623

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number01895/01.1
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: DAN STONE
Title or Position: OWNER
Credential: RPH
Phone: 601-656-2621