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General NPI Number Information
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NPI Number | 1033255005
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Entity Type | Individual
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Provider Name | EDDIE D RUTHERFORD RPH
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Gender | Male
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Dates
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Enumeration Date | 01/29/2007
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Last Update Date | 12/08/2025
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Provider Practice Location Address
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Address Line | 210 HOSPITAL CIR
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City | CHOCTAW
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State | MS
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Zip | 39350-6781
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Country | US
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Telephone | 601-389-4330
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Fax |
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Provider Business Mailing Address
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Address Line | 3450 ATTALA ROAD 1137
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City | KOSCIUSKO
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State | MS
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Zip | 39090-6506
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-8651
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License Number State | MS
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