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General NPI Number Information
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NPI Number | 1720009772
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Entity Type | Organization
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Legal Business Name | CITY REXALL DRUGS II INC
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Dates
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Enumeration Date | 07/22/2006
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 349 S MAIN ST
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City | PICAYUNE
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State | MS
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Zip | 39466-4415
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Country | US
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Telephone | 601-798-4761
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Fax | 601-798-4761
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Provider Business Mailing Address
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Address Line | 349 S MAIN ST
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City | PICAYUNE
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State | MS
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Zip | 39466-4415
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Country | US
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Telephone | 601-798-4761
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Fax | 601-798-4761
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Authorized Official
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Title or Position | PHARMACIST
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Name | STEPHEN PISARICH
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Credential |
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Telephone | 228-861-5076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 00179/1.1
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License Number State | MS
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