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General NPI Number Information
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NPI Number | 1023220944
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Entity Type | Organization
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Legal Business Name | TRUSTMORE INCORPORATED
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 03/25/2013
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Provider Practice Location Address
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Address Line | 102 METROPLEX BLVD SUITE A
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City | PEARL
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State | MS
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Zip | 39208-9202
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Country | US
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Telephone | 601-502-2350
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Fax | 601-939-1199
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Provider Business Mailing Address
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Address Line | 102 METROPLEX BLVD SUITE A
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City | PEARL
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State | MS
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Zip | 39208-9202
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Country | US
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Telephone | 601-502-2350
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Fax | 601-939-1199
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL KELLY
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Credential |
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Telephone | 601-946-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 06864026
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License Number State | MS
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