=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598841736
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | YARBER DRUG STORE INC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/31/2006
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 85 MAIN ST
-----------------------------------------------------
City | BELMONT
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38827
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-454-3371
-----------------------------------------------------
Fax | 662-454-7401
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 188
-----------------------------------------------------
City | BELMONT
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38827-0188
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-454-3371
-----------------------------------------------------
Fax | 662-454-7401
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER/PHARMACIST
-----------------------------------------------------
Name | MR. ROBERT H YARBER
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 662-454-3371
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 332B00000X
-----------------------------------------------------
Taxonomy Name | Durable Medical Equipment & Medical Supplies
-----------------------------------------------------
License Number | 00802011
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------