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Organization
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Active
Organization
MISSISSIPPI STATE DEPARTMENT OF HEALTH
Active
Other names
Pearl WIC Distribution Center
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MITCHELL ADCOCK CAO (CHIEF ADMINISTRATIVE OFFICER)
(601) 576-7635
Entity
Organization
Contact information
Practice address
110 CROSS PARK DR, SUITE C, PEARL, MS 39208-9016
(601) 939-0450
(601) 420-5160
Mailing address
570 E WOODROW WILSON AVE, JACKSON, MS 39216-4538
(601) 576-7635
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
—
NULL
Other
Enumeration date
05/16/2014
Last updated
05/16/2014
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