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General NPI Number Information
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NPI Number | 1568331544
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Entity Type | Organization
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Legal Business Name | ST. VINCENT DE PAUL COMMUNITY PHARMACY, INC.
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Dates
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Enumeration Date | 10/30/2025
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Last Update Date | 10/30/2025
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Provider Practice Location Address
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Address Line | 715B DIVISION ST
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City | BILOXI
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State | MS
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Zip | 39530-2209
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Country | US
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Telephone | 228-374-9097
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Fax | 228-374-4860
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Provider Business Mailing Address
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Address Line | PO BOX 1228
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City | BILOXI
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State | MS
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Zip | 39533-1228
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Country | US
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Telephone | 228-374-9097
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Fax | 228-374-4860
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. SAMUEL BURKE
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Credential |
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Telephone | 228-374-9097
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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 |
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License Number State |
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