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General NPI Number Information
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NPI Number | 1598816589
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Entity Type | Organization
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Legal Business Name | QUEST PHARMACY INC
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Dates
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Enumeration Date | 01/16/2007
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Last Update Date | 12/13/2016
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Provider Practice Location Address
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Address Line | 602 ADELINE ST STE E
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City | HATTIESBURG
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State | MS
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Zip | 39401-3802
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Country | US
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Telephone | 601-544-1489
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Fax | 601-544-1491
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Provider Business Mailing Address
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Address Line | 602 ADELINE ST STE E
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City | HATTIESBURG
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State | MS
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Zip | 39401-3802
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Country | US
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Telephone | 601-544-1489
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Fax | 601-544-1491
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Authorized Official
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Title or Position | PHARMACY DIRECTOR
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Name | SHARON DEVER
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Credential |
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Telephone | 601-544-1489
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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 | 06174023
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License Number State | MS
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