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General NPI Number Information
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NPI Number | 1669875100
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Entity Type | Individual
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Provider Name | TAMMY MCCRAY
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Gender | Female
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Dates
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Enumeration Date | 09/29/2014
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Last Update Date | 09/29/2014
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Provider Practice Location Address
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Address Line | 235 FRONTAGE RD
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City | PICAYUNE
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State | MS
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Zip | 39466-7587
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Country | US
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Telephone | 601-799-1063
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Fax | 601-799-1070
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Provider Business Mailing Address
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Address Line | 1580 HARBOR DR UNIT 117
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City | SLIDELL
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State | LA
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Zip | 70458-9253
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Country | US
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Telephone |
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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 | E-010118
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License Number State | MS
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