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Organization
DECATUR DRUGS INC
Active
Organization
DECATUR DRUGS INC
Active
Other names
Wheeler Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES AUSTIN BOGGAN RPH (OWNER)
(601) 635-2646
Entity
Organization
Contact information
Practice address
95 W BROAD ST, DECATUR, MS 39327-8959
(601) 635-2646
(601) 635-4039
Mailing address
PO BOX 98, DECATUR, MS 39327-0098
(601) 635-2646
(601) 635-4039
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E-6485
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030493
—
MS
Enumeration date
12/18/2006
Last updated
04/04/2019
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