# BAKERS PHARMACY INC

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

## Provider details

- **NPI number:** 1114047081
- **Authorized official:** MR. EDWIN LAMAR BAKER JR. RPH (MANAGER, CHIEF PHARMACIST)
- **Authorized official phone:** (601) 833-6361

## Contact information

- **Practice address:** 212 N JACKSON ST, BROOKHAVEN, MS 39601-3040
- **Practice address phone:** (601) 833-6361
- **Practice address fax:** (601) 833-3125
- **Mailing address:** PO BOX 236, BROOKHAVEN, MS 39602-0236
- **Mailing address phone:** (601) 833-6361
- **Mailing address fax:** (601) 833-3125

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 00104 01.1 | MS | Yes |

## Other

- **Enumeration date:** 04/02/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00030171 | — | MS |