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Organization
FOOT SOLUTIONS LLC
Active
Organization
FOOT SOLUTIONS LLC
Active
Other names
Foot Solutions LLC
Organization subpart
No
Provider details
NPI number
Authorized official
JERRIE SULLIVAN (OWNER)
(662) 456-0133
Entity
Organization
Contact information
Practice address
120 MARKET ST, WOODLAND, MS 39776-9104
(662) 456-0133
(662) 456-7335
Mailing address
120 MARKET ST, WOODLAND, MS 39776-9104
(662) 456-0133
(662) 456-7335
Taxonomy
Speciality
Code
Description
License number
State
3336C0002X
Clinic Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440529
—
MS
01
—
425800862D
BLUE CROSS BLUE SHIELD
MS
01
—
427371344B
BLUE CROSS BLUE SHIELD
MS
Enumeration date
05/16/2007
Last updated
07/10/2008
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