# PEARL RIVER DRUG CO.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1023031713
- **Authorized official:** ANDREW L FAILLA RPH (OWNER/PRESIDENT)
- **Authorized official phone:** (601) 798-4846

## Contact information

- **Practice address:** 510 S MAIN ST, POPLARVILLE, MS 39470
- **Practice address phone:** (601) 795-4239
- **Practice address fax:** (601) 795-4941
- **Mailing address:** PO BOX 10, PO BOX 10, PICAYUNE, MS 39466
- **Mailing address phone:** (601) 795-4239
- **Mailing address fax:** (601) 795-4941

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 00558/01.1 | MS | Yes |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 07/25/2006
- **Last updated:** 05/01/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00033553 | — | MS |