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General NPI Number Information
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NPI Number | 1073626636
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Entity Type | Organization
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Legal Business Name | MEDICAL ARTS PHARMACY OF COLUMBUS, INC.
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Dates
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Enumeration Date | 08/17/2006
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Last Update Date | 09/29/2009
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Provider Practice Location Address
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Address Line | 504 MILITARY RD
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City | COLUMBUS
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State | MS
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Zip | 39701-4681
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Country | US
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Telephone | 662-328-8660
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Fax | 662-328-1213
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Provider Business Mailing Address
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Address Line | 504 MILITARY RD
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City | COLUMBUS
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State | MS
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Zip | 39701-4681
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Country | US
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Telephone | 662-328-8660
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Fax | 662-328-1213
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Authorized Official
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Title or Position | CEO
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Name | MR. DONALD EDWARD WALDEN
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Credential |
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Telephone | 662-328-8660
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 00440865
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License Number State | MS
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