# FAMILY DRUG MART OF SUMRALL, LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** FAMILY DRUG MART OF SUMRALL
- **Organization subpart:** No

## Provider details

- **NPI number:** 1124679873
- **Authorized official:** JOSE MIGUEL YANEZ RPH (OWNER)
- **Authorized official phone:** (504) 338-7992

## Contact information

- **Practice address:** 4233 ROCKY BRANCH RD STE B, SUMRALL, MS 39482-4142
- **Practice address phone:** (769) 307-7050
- **Practice address fax:** (769) 307-7020
- **Mailing address:** 2299 SUNSET BLVD, SLIDELL, LA 70461-5605
- **Mailing address phone:** (504) 338-7992
- **Mailing address fax:** (985) 265-4550

## Taxonomy

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

## Other

- **Enumeration date:** 09/24/2019
- **Last updated:** 01/29/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330324 | — | MS |
| 05 | — | 3303247 | — | MS |