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General NPI Number Information
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NPI Number | 1780189811
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Entity Type | Organization
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Legal Business Name | TIN RX 809 INC
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Dates
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Enumeration Date | 03/29/2018
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Last Update Date | 10/10/2024
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Provider Practice Location Address
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Address Line | 2657 LAKELAND DRIVE
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City | FLOWOOD
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State | MS
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Zip | 39232
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Country | US
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Telephone | 601-588-2490
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Fax | 601-588-2491
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Provider Business Mailing Address
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Address Line | PO BOX 640
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City | BRASELTON
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State | GA
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Zip | 30517-0011
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Country | US
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Telephone | 601-588-2490
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Fax | 601-588-2491
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Authorized Official
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Title or Position | PRESIDENT
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Name | SYLVIA LIND
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Credential |
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Telephone | 601-588-2490
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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 |
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License Number State | MS
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