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General NPI Number Information
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NPI Number | 1215703285
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Entity Type | Organization
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Legal Business Name | MYERS PHARMACY LLC
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Dates
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Enumeration Date | 11/30/2023
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Last Update Date | 11/30/2023
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Provider Practice Location Address
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Address Line | 653 CONCORDIA AVENUE
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City | OXFORD
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State | MS
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Zip | 38655
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Country | US
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Telephone | 662-352-4145
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Fax |
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Provider Business Mailing Address
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Address Line | 302 LAKEWOOD HILLS DR
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City | OXFORD
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State | MS
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Zip | 38655-4478
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Country | US
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Telephone | 662-352-4145
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Fax |
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Authorized Official
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Title or Position | OWNER/MANAGER
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Name | DR. SAMUEL ANDREW MYERS
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Credential | PHARMD
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Telephone | 662-352-4145
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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 |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336H0001X
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Taxonomy Name | Home Infusion Therapy Pharmacy
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number |
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License Number State |
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