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General NPI Number Information
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NPI Number | 1942345574
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Entity Type | Organization
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Legal Business Name | PHARMACY MANAGEMENT GROUP LLC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 425 MAIN ST
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City | COLUMBUS
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State | MS
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Zip | 39701-4533
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Country | US
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Telephone | 662-328-1766
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Fax | 662-328-9273
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Provider Business Mailing Address
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Address Line | 425 MAIN ST
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City | COLUMBUS
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State | MS
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Zip | 39701-4533
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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 | PHRM OWNER
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Name | RONALD HARRIS
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Credential | RPH
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Telephone | 662-327-4025
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336L0003X
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Taxonomy Name | Long Term Care Pharmacy
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License Number | 00363
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License Number State | MS
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