=====================================================
General NPI Number Information
=====================================================
NPI Number | 1871094102
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALING HANDS PHARMACY SOLUTIONS
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2018
-----------------------------------------------------
Last Update Date | 06/16/2018
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 13010 HWY 18
-----------------------------------------------------
City | RAYMOND
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39154-9520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-540-5303
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1040 TORREY RD
-----------------------------------------------------
City | UTICA
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 39175-9520
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 601-540-5303
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHARMACIST/CEO
-----------------------------------------------------
Name | DR. CEDRIC D. TORRY
-----------------------------------------------------
Credential | PHARM D
-----------------------------------------------------
Telephone | 601-540-5303
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | E-13690
-----------------------------------------------------
License Number State | MS
-----------------------------------------------------