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General NPI Number Information
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NPI Number | 1750431334
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Entity Type | Organization
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Legal Business Name | S & W PHARMACY INC
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 06/16/2008
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Provider Practice Location Address
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Address Line | 116 S CUMMINGS ST
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City | FULTON
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State | MS
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Zip | 38843-1802
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Country | US
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Telephone | 662-862-9025
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Fax |
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Provider Business Mailing Address
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Address Line | 116 S CUMMINGS ST
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City | FULTON
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State | MS
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Zip | 38843-1802
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Country | US
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Telephone | 662-862-9025
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Fax |
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Authorized Official
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Title or Position | PHARMACIST
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Name | MR. TRENT BENNETT
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Credential |
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Telephone | 662-862-9025
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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 | 00532
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License Number State | MS
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