# TLL&W INC DBA BUCKLEYS PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Other names:** BUCKLEYS PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1063557718
- **Authorized official:** CULLIE TAYLOR ROBERTS JR. R.PH. (PHARMACIST-OWNER)
- **Authorized official phone:** (662) 843-3654

## Contact information

- **Practice address:** 301 HOSPITAL DR, CLEVELAND, MS 38732-2358
- **Practice address phone:** (662) 843-3654
- **Practice address fax:** (662) 843-3622
- **Mailing address:** 301 HOSPITAL DR, CLEVELAND, MS 38732-2358
- **Mailing address phone:** (662) 843-3654
- **Mailing address fax:** (662) 843-3622

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 00509 | MS | Yes |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0030389 | — | MS |
| 01 | — | 2515192 | NCPDP | MS |