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General NPI Number Information
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NPI Number | 1801506043
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Entity Type | Individual
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Provider Name | SAMUEL ANDREW MYERS PHARM.D.
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Gender | Male
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Dates
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Enumeration Date | 11/29/2022
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Last Update Date | 06/25/2024
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Provider Practice Location Address
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Address Line | 653 CONCORDIA AVE
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City | OXFORD
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State | MS
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Zip | 38655-1982
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Country | US
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Telephone | 662-638-6382
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Fax | 833-623-3054
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Provider Business Mailing Address
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Address Line | 302 LAKEWOOD HILL DRIVE
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City | OXFORD
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State | MS
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Zip | 38655
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Country | US
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Telephone | 662-352-4145
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 16903
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | E-11824
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License Number State | MS
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