# MEDICAL PLAZA ON ALCORN LLC

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

## Provider details

- **NPI number:** 1497852602
- **Authorized official:** MR. RICK W QUINN (RPH)
- **Authorized official phone:** (662) 286-6991

## Contact information

- **Practice address:** 111 ALCORN DR, CORINTH, MS 38834-9359
- **Practice address phone:** (662) 286-6991
- **Practice address fax:** (662) 287-8087
- **Mailing address:** 111 ALCORN DR, CORINTH, MS 38834-9359
- **Mailing address phone:** (662) 286-6991
- **Mailing address fax:** (662) 287-8087

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 0313501.1 | MS | Yes |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 09/01/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00095265 | — | MS |
| 05 | — | 00440678 | — | MS |