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Organization
GENTEX PHARMA
Active
Organization
GENTEX PHARMA
Active
Other names
Gentex Pharma LLC
Organization subpart
No
Provider details
NPI number
Authorized official
FORD JENNINGS MUNDY PERSON IN CHARGE (OWNER)
(870) 243-1687
Entity
Organization
Contact information
Practice address
121 MARKETRIDGE DR, SUITE C, RIDGELAND, MS 39157-6027
(601) 990-9497
(601) 510-9318
Mailing address
121 MARKETRIDGE DR, SUITE C, RIDGELAND, MS 39157-6027
(601) 990-9497
(601) 510-9318
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
06677/6.1
MS
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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