MEDICARE: SAV-ON-DRUGS OF COLUMBIA, 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
1	314000000X	Skilled Nursing Facility
2	333600000X	Pharmacy

Other Identifiers

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

General Provider Information

NPI Number	:	1952495459
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAV-ON-DRUGS OF COLUMBIA, INC

Provider Business Mailing Address
First Line	:	345 BROAD ST
Second Line	:	P.O. BOX 163
City	:	COLUMBIA
State	:	MS
Zip	:	39429-2964
Country	:	US
Telephone Number	:	601-736-6321
Fax Number	:	601-736-6253

Provider Business Practice Location Address
First Line	:	345 BROAD ST
Second Line	:
City	:	COLUMBIA
State	:	MS
Zip	:	39429-2964
Country	:	US
Telephone Number	:	601-736-6321
Fax Number	:	601-736-6253

Authorized Official
Title or Position	:	PRES.
Name	:	DEBORAH MCDANIEL
Credential	:
Telephone Number	:	601-736-6321

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	02/10/2009

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