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General NPI Number Information
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NPI Number | 1922258730
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Entity Type | Organization
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Legal Business Name | BATTLEFIELD CLINIC DRUGS
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Dates
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Enumeration Date | 09/29/2008
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Last Update Date | 10/10/2008
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Provider Practice Location Address
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Address Line | 2080 S FRONTAGE RD STE N
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City | VICKSBURG
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State | MS
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Zip | 39180-5328
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Country | US
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Telephone | 601-636-2236
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Fax | 601-636-2264
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Provider Business Mailing Address
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Address Line | 2080 S FRONTAGE RD STE N
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City | VICKSBURG
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State | MS
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Zip | 39180-5328
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOHN STOREY
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Credential |
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Telephone | 601-636-3374
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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 | 07824/01.1
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License Number State | MS
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