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General NPI Number Information
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NPI Number | 1134493851
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Entity Type | Organization
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Legal Business Name | TOWNE MARKET
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Dates
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Enumeration Date | 02/27/2012
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Last Update Date | 02/27/2012
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Provider Practice Location Address
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Address Line | 6 SIEBENKITTEL CIR STE B
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City | CARRIERE
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State | MS
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Zip | 39426-8778
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Country | US
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Telephone | 601-353-5523
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Fax | 225-282-1004
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Provider Business Mailing Address
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Address Line | 6 SIEBENKITTEL CIR STE B
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City | CARRIERE
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State | MS
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Zip | 39426-8778
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Country | US
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Telephone | 601-353-5523
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Fax | 225-282-1004
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MR. FRANK BATISTE
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Credential |
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Telephone | 601-353-5523
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 1079/1.1
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License Number State | MS
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