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General NPI Number Information
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NPI Number | 1245611094
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Entity Type | Organization
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Legal Business Name | REDIMEDS PHARMACY AT HOME, LLC
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Dates
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Enumeration Date | 06/17/2015
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Last Update Date | 06/17/2015
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Provider Practice Location Address
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Address Line | 3466 MCCULLOUGH BLVD STE D-1
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City | BELDEN
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State | MS
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Zip | 38826-9468
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Country | US
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Telephone | 662-842-6204
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Fax |
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Provider Business Mailing Address
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Address Line | 3466 MCCULLOUGH BLVD STE D-1
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City | BELDEN
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State | MS
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Zip | 38826-9468
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Country | US
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Telephone | 662-842-6204
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Fax |
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Authorized Official
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Title or Position | OWNER/ PHARMACIST
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Name | DEBRALEE CARROLL
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Credential |
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Telephone | 662-231-3243
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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 | 14375/1.1
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License Number State | MS
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