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Organization
GILLIS DRUGSTORE
Active
Organization
GILLIS DRUGSTORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TOM E ASSAF RPH (PHARMACIST)
(601) 684-2621
Entity
Organization
Contact information
Practice address
219 STATE STREET, MCCOMB, MS 39648
(601) 684-2621
(601) 684-2622
Mailing address
219 STATE STREET, MCCOMB, MS 39648
(601) 684-2621
(601) 684-2622
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
00972
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030161
—
MS
01
—
00972
BOARD OF PHARMACY PERMIT
MS
Enumeration date
08/04/2006
Last updated
03/07/2023
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