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Organization
BORROUMS REXALL DRUG STORE INC
Active
Organization
BORROUMS REXALL DRUG STORE INC
Active
Other names
Borroum's Drug Store Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE MITCHELL (PRESIDENT)
(662) 286-3361
Entity
Organization
Contact information
Practice address
604 E WALDRON ST, CORINTH, MS 38834-4863
(662) 286-3361
(662) 286-3362
Mailing address
604 E WALDRON ST, CORINTH, MS 38834-4863
(662) 286-3361
(662) 286-3362
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
00202/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030473
—
MS
01
—
2123758
PK
—
Enumeration date
02/12/2010
Last updated
03/01/2017
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