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General NPI Number Information
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NPI Number | 1609952175
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Entity Type | Organization
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Legal Business Name | DURST DISCOUNT DRUGS, INC
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Dates
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Enumeration Date | 10/27/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2122 CLAY ST
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City | VICKSBURG
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State | MS
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Zip | 39183-3119
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Country | US
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Telephone | 601-636-5042
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Fax | 601-638-7901
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Provider Business Mailing Address
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Address Line | 2122 CLAY ST
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City | VICKSBURG
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State | MS
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Zip | 39183-3119
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Country | US
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Telephone | 601-636-5042
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Fax | 601-638-7901
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JOSEPH LOW DURST
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Credential | R.PH.
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Telephone | 601-636-5042
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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 | 00693/01.1
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License Number State | MS
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