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General NPI Number Information
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NPI Number | 1568145852
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Entity Type | Individual
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Provider Name | KALLIE HOPSON PHARMD
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Gender | Female
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Dates
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Enumeration Date | 08/11/2023
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Last Update Date | 08/11/2023
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Provider Practice Location Address
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Address Line | 203 N NEWBURGER AVE
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City | BRUCE
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State | MS
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Zip | 38915-9430
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Country | US
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Telephone | 662-983-4071
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Fax | 662-983-4072
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Provider Business Mailing Address
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Address Line | PO BOX 656
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City | BRUCE
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State | MS
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Zip | 38915-0656
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Country | US
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Telephone | 662-983-4071
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Fax | 662-983-4072
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-101229
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License Number State | MS
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