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General NPI Number Information
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NPI Number | 1164062667
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Entity Type | Organization
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Legal Business Name | MITCHELLS PHARMACY INC
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Dates
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Enumeration Date | 01/13/2020
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Last Update Date | 01/13/2020
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Provider Practice Location Address
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Address Line | 202 E MAIN ST
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City | JONESBORO
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State | LA
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Zip | 71251-3202
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Country | US
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Telephone | 318-259-7466
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Fax | 318-259-8019
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Provider Business Mailing Address
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Address Line | 202 E MAIN ST
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City | JONESBORO
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State | LA
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Zip | 71251-3202
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Country | US
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Telephone | 318-259-7466
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Fax | 318-259-8019
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Authorized Official
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Title or Position | OWNER
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Name | DWAYNE R MITCHELL
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Credential | RPH
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Telephone | 318-259-7466
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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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