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General NPI Number Information
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NPI Number | 1578678827
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Entity Type | Organization
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Legal Business Name | HUDSON PHARMACY, INC.
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Dates
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Enumeration Date | 08/20/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 1635 COLUMBIA AVE
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City | PRENTISS
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State | MS
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Zip | 39474
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Country | US
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Telephone | 601-792-4467
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Fax | 601-792-8191
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Provider Business Mailing Address
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Address Line | PO BOX 658
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City | PRENTISS
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State | MS
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Zip | 39474-0658
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Country | US
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Telephone | 601-792-4467
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Fax | 601-792-8191
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Authorized Official
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Title or Position | PHARMACY AND STORE MANAGER
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Name | DR. JOSEPH KENDRICK WAITS
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Credential | PHARMD
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Telephone | 601-792-4467
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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 | 00133
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License Number State | MS
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