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General NPI Number Information
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NPI Number | 1699331868
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Entity Type | Organization
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Legal Business Name | FULTON SPECIALTY PHARMACY, LLC
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Dates
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Enumeration Date | 05/14/2019
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Last Update Date | 05/14/2019
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Provider Practice Location Address
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Address Line | 1509 S ADAMS ST STE D
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City | FULTON
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State | MS
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Zip | 38843-6621
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Country | US
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Telephone | 662-245-3080
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Fax | 888-828-2149
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Provider Business Mailing Address
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Address Line | 1509 S ADAMS ST STE D
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City | FULTON
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State | MS
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Zip | 38843-6621
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Country | US
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Telephone | 662-245-3080
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Fax | 888-828-2149
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Authorized Official
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Title or Position | OWNER
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Name | MR. THOMAS W FRANCIS
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Credential |
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Telephone | 662-245-3080
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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