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General NPI Number Information
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NPI Number | 1447393418
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Entity Type | Organization
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Legal Business Name | ANDERSON DRUGS INC
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Dates
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Enumeration Date | 02/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 5796 US HWY 11
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City | PURVIS
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State | MS
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Zip | 39475
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Country | US
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Telephone | 601-794-5525
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Fax | 601-794-2741
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Provider Business Mailing Address
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Address Line | PO BOX 407
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City | PURVIS
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State | MS
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Zip | 39475-0407
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Country | US
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Telephone | 601-794-5525
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Fax | 601-794-2741
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Authorized Official
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Title or Position | SECRETARY
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Name | MRS. LORI ANN ANDERSON
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Credential |
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Telephone | 601-794-5525
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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 | 0225601.1
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License Number State | MS
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