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Organization
CITY DRUG STORE OF HAZLEHURST, INC.
Active
Organization
CITY DRUG STORE OF HAZLEHURST, INC.
Active
Other names
Rose's Super Discount Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL HENRY ROSE R. PH. (OWNER)
(601) 894-1222
Entity
Organization
Contact information
Practice address
218 CALDWELL DR, HAZLEHURST, MS 39083-2712
(601) 894-1222
(601) 894-1522
Mailing address
218 CALDWELL DR, HAZLEHURST, MS 39083-2712
(601) 894-1222
(601) 894-1522
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
002093
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030881
—
MS
Enumeration date
10/16/2006
Last updated
12/23/2020
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