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General NPI Number Information
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NPI Number | 1356477863
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Entity Type | Organization
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Legal Business Name | JOHNS' DISCOUNT DRUGS
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Dates
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Enumeration Date | 02/26/2007
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Last Update Date | 03/04/2022
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Provider Practice Location Address
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Address Line | 410 W MAIN AVE
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City | LUMBERTON
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State | MS
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Zip | 39455-2437
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Country | US
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Telephone | 601-796-4761
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Fax | 601-796-4764
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Provider Business Mailing Address
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Address Line | 410 W MAIN AVE
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City | LUMBERTON
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State | MS
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Zip | 39455-2437
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Country | US
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Telephone | 601-796-4761
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Fax | 601-796-4764
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Authorized Official
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Title or Position | PHARMACIST
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Name | BARRY LEWIS WAITS
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Credential |
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Telephone | 601-796-4761
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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 | 920IJL
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License Number State | MS
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