# METRO PHARMACY INC

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

## Provider details

- **NPI number:** 1124169057
- **Authorized official:** MR. GLENN D BRANTLEY PHARMACIST (VICE PRESIDENT. SECRETARY TREASURE)
- **Authorized official phone:** (601) 346-5567

## Contact information

- **Practice address:** 1815 HOSPITAL DR, JACKSON, MS 39204-3425
- **Practice address phone:** (601) 346-5567
- **Practice address fax:** (601) 346-7371
- **Mailing address:** 1815 HOSPITAL DR, SUITE 118, JACKSON, MS 39204-3425
- **Mailing address phone:** (601) 346-5567
- **Mailing address fax:** (601) 346-7371

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 02268 01.1 | MS | Yes |

## Other

- **Enumeration date:** 02/12/2007
- **Last updated:** 08/21/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00030365 | — | MS |
| 01 | — | 2517021 | NABP | — |