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General NPI Number Information
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NPI Number | 1730446923
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Entity Type | Organization
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Legal Business Name | RIDGELAND APOTHECARY, LLC.
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Dates
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Enumeration Date | 04/12/2012
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Last Update Date | 04/07/2016
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Provider Practice Location Address
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Address Line | 500 HIGHWAY 51 SUITE Q
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City | RIDGELAND
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State | MS
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Zip | 39157-2599
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Country | US
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Telephone | 601-981-0070
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Fax | 601-981-4513
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Provider Business Mailing Address
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Address Line | 500 HIGHWAY 51 NORTH SUITE Q
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City | RIDGELAND
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State | MS
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Zip | 39157
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Country | US
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Telephone | 601-981-0070
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Fax | 601-981-4513
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Authorized Official
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Title or Position | PHARMACIST IN CHARGE
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Name | DR. LAURA CIALONE
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Credential | PHARM D.
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Telephone | 601-981-0070
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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 | 10816/1.1
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License Number State | MS
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