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General NPI Number Information
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NPI Number | 1346096898
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Entity Type | Organization
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Legal Business Name | PRECISION PHARMACY WELLNESS AND COMPOUNDING LLC
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Dates
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Enumeration Date | 04/25/2024
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Last Update Date | 04/25/2024
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Provider Practice Location Address
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Address Line | 6766 U S HIGHWAY 98
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City | HATTIESBURG
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State | MS
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Zip | 39402-8443
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Country | US
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Telephone | 601-255-0010
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Fax | 601-255-0309
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Provider Business Mailing Address
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Address Line | 6766 U S HIGHWAY 98
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City | HATTIESBURG
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State | MS
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Zip | 39402-8443
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Country | US
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Telephone | 601-255-0010
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Fax | 601-255-0309
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Authorized Official
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Title or Position | VICE-PRESIDENT
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Name | MR. KENNETH EARL CRAWFORD III
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Credential | RPH
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Telephone | 601-255-0010
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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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