Healthcare Provider Details

I. General information

NPI: 1912844606
Provider Name (Legal Business Name): HOME MEDICAL PHARMACY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/30/2026
Last Update Date: 04/30/2026
Certification Date: 04/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 CUNNINGHAM STREET
TERRY MS
39170
US

IV. Provider business mailing address

PO BOX 515
TERRY MS
39170-0515
US

V. Phone/Fax

Practice location:
  • Phone: 601-983-7168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code333600000X
TaxonomyPharmacy
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code3336C0003X
TaxonomyCommunity/Retail Pharmacy
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code183700000X
TaxonomyPharmacy Technician
License Number
License Number State

VIII. Authorized Official

Name: CANDACE HARVEY
Title or Position: COMPLIANCE OFFICER
Credential:
Phone: 601-983-7168