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General NPI Number Information
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NPI Number | 1760409585
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Entity Type | Organization
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Legal Business Name | VILLAGE PHARMACY, L.L.C.
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Dates
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Enumeration Date | 07/16/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 560 WEATHERSBY RD SUITE 170
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City | HATTIESBURG
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State | MS
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Zip | 39402-1164
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Country | US
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Telephone | 601-296-0807
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Fax | 601-450-0424
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Provider Business Mailing Address
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Address Line | 560 WEATHERSBY RD SUITE 170
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City | HATTIESBURG
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State | MS
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Zip | 39402-1164
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Country | US
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Telephone | 601-296-0807
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Fax | 601-450-0424
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Authorized Official
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Title or Position | PHARMACIST/OWNER
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Name | RICHARD BRINSON
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Credential | RPH
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Telephone | 601-296-0807
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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 | 04114-01VH
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License Number State | MS
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