# TYSON DRUGS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Tyson Drugs Inc LTC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194441493
- **Authorized official:** ROBERT H LOMENICK RPH (OWNER)
- **Authorized official phone:** (662) 252-2321

## Contact information

- **Practice address:** 145 E VAN DORN AVE, HOLLY SPRINGS, MS 38635-3025
- **Practice address phone:** (662) 252-2321
- **Practice address fax:** (662) 252-1656
- **Mailing address:** PO BOX 10, HOLLY SPRINGS, MS 38635-0010
- **Mailing address phone:** (662) 252-2321
- **Mailing address fax:** (662) 252-1656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 10/18/2022
- **Last updated:** 07/24/2023