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Organization
MMSS ANCILLARY SERVICES INC
Active
Organization
MMSS ANCILLARY SERVICES INC
Active
Other names
Senior Rx
Organization subpart
No
Provider details
NPI number
Authorized official
VALERIE SULLIVAN (DIRECTOR OF PHARMACY SERVICES)
(662) 840-1022
Entity
Organization
Contact information
Practice address
2800 W MAIN ST, TUPELO, MS 38801-3027
(662) 840-1022
(662) 844-4677
Mailing address
2800 W MAIN ST, TUPELO, MS 38801-3027
(662) 840-1022
(662) 840-4677
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
10146/2.3
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2133265
PK
—
Enumeration date
12/29/2011
Last updated
11/18/2016
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