Healthcare Provider Details
I. General information
NPI: 1821366279
Provider Name (Legal Business Name): JONETHAN MICHAEL MORRIS PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 12/13/2011
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
146 S THOMAS ST STE B
TUPELO MS
38801-5328
US
IV. Provider business mailing address
146 S THOMAS ST STE B
TUPELO MS
38801-5328
US
V. Phone/Fax
- Phone: 662-260-3366
- Fax: 662-269-1568
- Phone: 662-260-3366
- Fax: 662-269-1568
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 251F00000X |
| Taxonomy | Home Infusion Agency |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 261QI0500X |
| Taxonomy | Infusion Therapy Clinic/Center |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 183500000X |
| Taxonomy | Pharmacist |
| License Number | P11723 |
| License Number State | MS |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: