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Organization
ADVANTAGE APOTHECARY, LLCF
Active
Organization
ADVANTAGE APOTHECARY, LLCF
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM C. PIERCE PHARMD (PIC)
(601) 450-0294
Entity
Organization
Contact information
Practice address
5296 OLD HIGHWAY 11 STE 4, HATTIESBURG, MS 39402-8380
(601) 450-0294
(601) 450-0295
Mailing address
5296 OLD HIGHWAY 11 STE 4, HATTIESBURG, MS 39402-8380
(601) 450-0294
(601) 450-0295
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
13438/2.2
MS
3336S0011X
Specialty Pharmacy
Primary
13438/2.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13438/2.2
STATE BOARD PHARMACY PERMIT
MS
01
—
CS13438/2.2
STATE PHARMACY CONTROL SUBSTANCE PERMIT
MS
Enumeration date
06/23/2014
Last updated
06/23/2014
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