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Organization
IUKA PHARMACY SERVICES LLC
Active
Organization
IUKA PHARMACY SERVICES LLC
Active
Other names
Iuka Discount Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY LEE GRIFFIN PHARMD (OWNER)
(662) 423-9039
Entity
Organization
Contact information
Practice address
1411 W QUITMAN ST, IUKA, MS 38852-1130
(662) 423-9039
(662) 423-9318
Mailing address
1411 W QUITMAN ST, IUKA, MS 38852-1130
(662) 423-9039
(662) 423-9318
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
00827011
MS
333600000X
Pharmacy
00827011
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00092754
—
MS
01
—
04158389
DME MEDICAID
MS
Enumeration date
07/19/2006
Last updated
09/10/2021
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