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General NPI Number Information
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NPI Number | 1487159299
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Entity Type | Organization
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Legal Business Name | COMMUNITY DISCOUNT PHARMACY INC
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Dates
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Enumeration Date | 03/26/2018
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Last Update Date | 12/19/2024
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Provider Practice Location Address
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Address Line | 100 N FRONT ST
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City | SENATOBIA
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State | MS
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Zip | 38668-2136
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Country | US
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Telephone | 662-562-5268
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Fax | 662-562-6136
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Provider Business Mailing Address
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Address Line | 305 NORFLEET DR
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City | SENATOBIA
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State | MS
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Zip | 38668-2205
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Country | US
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Telephone | 662-562-5268
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Fax | 662-562-6136
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Authorized Official
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Title or Position | OWNER
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Name | MOLLIE KIDDER SPENCER
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Credential | PHARMD
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Telephone | 662-562-5268
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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 | 01282
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License Number State | MS
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