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General NPI Number Information
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NPI Number | 1497133391
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Entity Type | Organization
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Legal Business Name | MISSISSIPPI SENIOR CARE
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Dates
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Enumeration Date | 05/11/2015
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Last Update Date | 07/28/2021
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Provider Practice Location Address
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Address Line | 86 S THOMAS ST
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City | TUPELO
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State | MS
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Zip | 38801-4355
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Country | US
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Telephone | 662-844-0400
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Fax | 662-844-5605
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Provider Business Mailing Address
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Address Line | 86 S THOMAS ST
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City | TUPELO
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State | MS
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Zip | 38801-4355
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Country | US
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Telephone | 662-844-0400
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Fax | 662-844-5605
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JAMES MARC GUNNELLS
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Credential | R.PH
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Telephone | 662-678-3330
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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