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General NPI Number Information
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NPI Number | 1144753823
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Entity Type | Organization
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Legal Business Name | QUINN'S FAMILY PHARMACY, INC
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Dates
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Enumeration Date | 04/10/2017
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Last Update Date | 07/22/2020
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Provider Practice Location Address
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Address Line | 24944 HWY 15
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City | UNION
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State | MS
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Zip | 39365-1565
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Country | US
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Telephone | 769-222-1054
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Fax | 769-222-1078
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Provider Business Mailing Address
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Address Line | 24944 HWY 15
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City | UNION
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State | MS
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Zip | 39365-1565
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Country | US
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Telephone | 769-222-1054
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Fax | 769-222-1078
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Authorized Official
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Title or Position | PRESIDENT/PHARMACIST IN CHARGE
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Name | TESA QUINN
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Credential | PHARM D
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Telephone | 601-616-4212
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | 15398
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State |
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