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NPI Code Detail

MEDICARE: TABOR DRUGS, INC.

MEDICARE: TABOR DRUGS, INC.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13336C0003XCommunity/Retail Pharmacy00572/01.1MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
22505254OTHERMSNABP NUMBER

General Provider Information

NPI Number : 1467546341
Entity Type Code : Organization
Provider Name (Legal Business Name) : TABOR DRUGS, INC.
Provider Business Mailing Address
First Line : 104 WEST MAIN STREET
Second Line :
City : LOUISVILLE
State : MS
Zip : 39339-2620
Country : US
Telephone Number : 662-773-5363
Fax Number : 662-773-9951
Provider Business Practice Location Address
First Line : 104 W MAIN ST
Second Line :
City : LOUISVILLE
State : MS
Zip : 39339-2620
Country : US
Telephone Number : 662-773-5363
Fax Number : 662-773-9951
Authorized Official
Title or Position : PRESIDENT/PHARMACIST
Name : MARY MARTHA TABOR
Credential :
Telephone Number : 662-773-5363
Provider Enumeration Date : 10/03/2006
Last Update Date : 04/16/2015

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Directions to “TABOR DRUGS, INC. ” Practice Location

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