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General NPI Number Information
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NPI Number | 1093884025
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Entity Type | Organization
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Legal Business Name | SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC.
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/17/2022
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Provider Practice Location Address
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Address Line | 109 W WALNUT ST
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City | CHARLESTON
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State | MS
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Zip | 38921-2242
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Country | US
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Telephone | 662-647-5172
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Fax |
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Provider Business Mailing Address
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Address Line | 109 W WALNUT ST
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City | CHARLESTON
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State | MS
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Zip | 38921-2242
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Country | US
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Telephone | 662-647-5172
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. ROBERT L SALMON
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Credential | R.PH.
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Telephone | 662-647-5172
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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 | E05166
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License Number State | MS
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