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General NPI Number Information
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NPI Number | 1831645373
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Entity Type | Organization
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Legal Business Name | THE PHARMACY OF MARKS
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Dates
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Enumeration Date | 08/25/2016
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Last Update Date | 08/25/2016
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Provider Practice Location Address
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Address Line | 1039 MARTIN LUTHER KING DR
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City | MARKS
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State | MS
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Zip | 38646-1808
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Country | US
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Telephone | 662-326-8609
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 5105
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City | MERIDIAN
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State | MS
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Zip | 39302-5105
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Country | US
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Telephone | 601-693-2655
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DAVID MAJURE
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Credential |
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Telephone | 601-693-2655
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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 | 06997/1.1
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License Number State | MS
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