# AZALEA PHARMACY LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1407283989
- **Authorized official:** MR. JEFFREY WAYNE ROLLINS (CFO)
- **Authorized official phone:** (228) 334-2411

## Contact information

- **Practice address:** 1019 GOVERNMENT ST, SUITE F, OCEAN SPRINGS, MS 39564-3860
- **Practice address phone:** (228) 818-5111
- **Practice address fax:** (228) 818-5113
- **Mailing address:** 1801 GOVERNMENT ST, SUITE C, OCEAN SPRINGS, MS 39564-3942
- **Mailing address phone:** (228) 818-5111

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 12664/1.1 | MS | Yes |

## Other

- **Enumeration date:** 09/30/2013
- **Last updated:** 09/30/2013