# CEDAR LAKE PHARMACY

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- **Entity:** Organization
- **Status:** Active
- **Parent organization:** -
- **Other names:** Lee Pharmacy
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1275986531
- **Legal business name:** -
- **Authorized official:** HANG NGUYEN PHARMD (MANAGER)
- **Authorized official phone:** (228) 276-9009

## Contact information

- **Practice address:** 917 DIVISION ST STE B, BILOXI, MS 39530-3001
- **Practice address phone:** (228) 280-8931
- **Practice address fax:** (228) 280-8915
- **Mailing address:** 921 CEDAR LAKE RD STE F, BILOXI, MS 39532-2126
- **Mailing address phone:** (228) 280-8931
- **Mailing address fax:** (228) 280-8915

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 07/21/2016
- **Last updated:** 06/09/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 007728373 | — | MS |
| 01 | — | 1275986531 | NPI | MS |