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General NPI Number Information
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NPI Number | 1437513876
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Entity Type | Organization
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Legal Business Name | THE TRANSPLANT PHARMACY, LLC
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Dates
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Enumeration Date | 04/12/2016
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Last Update Date | 04/13/2022
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Provider Practice Location Address
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Address Line | 630 LAKELAND EAST DR STE B
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City | FLOWOOD
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State | MS
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Zip | 39232-9565
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Country | US
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Telephone | 769-230-8335
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Fax | 769-230-8337
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Provider Business Mailing Address
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Address Line | 630 LAKELAND EAST DR STE B
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City | FLOWOOD
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State | MS
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Zip | 39232-9565
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Country | US
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Telephone | 769-230-8335
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Fax | 769-230-8337
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Authorized Official
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Title or Position | VICE PRESIDENT
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Name | JAMES GULLEY
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Credential | PHARMD.
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Telephone | 769-230-8335
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336S0011X
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Taxonomy Name | Specialty 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 | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number |
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License Number State | MS
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