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Organization
PHARMAKEUS INC
Active
Organization
PHARMAKEUS INC
Active
Other names
MARTYS PHARMACY AND COMPOUNDING CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
RONNIE BAGWELL RPH (OWNER AND PRESIDENT)
(601) 932-2027
Entity
Organization
Contact information
Practice address
1042 RIVER OAKS DR, FLOWOOD, MS 39232-9594
(601) 932-2027
(601) 936-2166
Mailing address
1042 RIVER OAKS DR, FLOWOOD, MS 39232-9594
(601) 932-2027
(601) 936-2166
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
01771/1.1
MS
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330225
—
MS
01
—
2044831
PK
—
Enumeration date
11/14/2006
Last updated
03/01/2017
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