# WESTSIDE PHARMACY & GIFTS

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

## Provider details

- **NPI number:** 1063005155
- **Authorized official:** JOHN RUCKER (MEMBER/OWNER)
- **Authorized official phone:** (662) 346-8812

## Contact information

- **Practice address:** 1653 N. COLEY RD., TUPELO, MS 38801-3880
- **Practice address phone:** (662) 816-5574
- **Mailing address:** 1653 N COLEY RD, TUPELO, MS 38801-6931
- **Mailing address phone:** (662) 346-8812
- **Mailing address fax:** (662) 553-4165

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 02/19/2021
- **Last updated:** 09/25/2024