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Organization
SULLIVAN'S DISCOUNT DRUGS INC.
Active
Organization
SULLIVAN'S DISCOUNT DRUGS INC.
Active
Other names
Sullivan's Discount Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID CHARLES HUDSON R.PH. (PHARMACIST)
(662) 289-3234
Entity
Organization
Contact information
Practice address
109 NORTHSIDE SHOPPING CENTER, HWY 12 W, KOSCIUSKO, MS 39090
(662) 289-3234
(662) 289-3030
Mailing address
109 NORTHSIDE SHOPPING CENTER, HWY 12 W, KOSCIUSKO, MS 39090
(662) 289-3234
(662) 289-3030
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
00233
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
3336L0003X
Long Term Care Pharmacy
00233
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00034452
—
MS
01
—
2505026
NCPDP #
MS
Enumeration date
07/09/2006
Last updated
08/18/2021
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