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General NPI Number Information
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NPI Number | 1417236894
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI DISCOUNT DRUGS LLC
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Dates
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Enumeration Date | 08/16/2011
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Last Update Date | 08/22/2011
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Provider Practice Location Address
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Address Line | 276 NISSAN PKWY STE 300
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City | CANTON
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State | MS
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Zip | 39046-7006
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Country | US
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Telephone | 601-855-7330
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Fax | 601-855-7332
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Provider Business Mailing Address
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Address Line | 195 E PEACE ST
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City | CANTON
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State | MS
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Zip | 39046-4519
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Country | US
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Telephone | 601-859-3939
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Fax | 601-855-2133
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Authorized Official
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Title or Position | MEMBER
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Name | MR. MICHAEL C MURPHY
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Credential |
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Telephone | 601-859-3939
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | 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 | 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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Taxonomy #3
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 09091/1.1
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License Number State | MS
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