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General NPI Number Information
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NPI Number | 1184710071
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Entity Type | Organization
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Legal Business Name | SUNFLOWER DISCOUNT PHARMACY LLC
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Dates
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Enumeration Date | 10/05/2006
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Last Update Date | 01/19/2016
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Provider Practice Location Address
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Address Line | 840 N OAK AVE
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City | RULEVILLE
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State | MS
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Zip | 38771-3227
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Country | US
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Telephone | 662-756-4381
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Fax | 662-756-2045
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Provider Business Mailing Address
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Address Line | 840 N OAK AVE
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City | RULEVILLE
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State | MS
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Zip | 38771-3227
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Country | US
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Telephone | 662-756-4381
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Fax | 662-756-2045
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Authorized Official
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Title or Position | PHARCIST IN CHARGE
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Name | THOMAS SPELL
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Credential |
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Telephone | 662-756-4381
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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 | 1179511
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License Number State | MS
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