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General NPI Number Information
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NPI Number | 1568772002
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Entity Type | Individual
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Provider Name | TED PLUNK RPH
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Gender | Male
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 599 W VETERANS BLVD
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City | CALHOUN CITY
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State | MS
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Zip | 38916-5501
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Country | US
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Telephone | 662-628-5811
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Fax | 662-628-1247
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Provider Business Mailing Address
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Address Line | 473 HIGHWAY 9 N
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City | BRUCE
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State | MS
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Zip | 38915-9514
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Country | US
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Telephone | 662-983-8835
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Fax |
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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 | E3766
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License Number State | MS
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