# SENATOBIA CITY DRUG CO INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Senatobia City Drug Co Inc
- **Organization subpart:** No

## Provider details

- **NPI number:** 1508963430
- **Authorized official:** LYNN BARHAM RPH (OWNER)
- **Authorized official phone:** (662) 562-8042

## Contact information

- **Practice address:** 122 NORFLEET DR, SENATOBIA, MS 38668-2220
- **Practice address phone:** (662) 562-8042
- **Practice address fax:** (662) 562-0644
- **Mailing address:** 122 NORFLEET DR, SENATOBIA, MS 38668-2220

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 00121011 | MS | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 09/20/2006
- **Last updated:** 11/21/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00030821 | — | MS |
| 05 | — | 00440236 | — | MS |
| 01 | — | 2507056 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |