# THOMAS PHARMACY GARDINER CENTER LLC

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

## Provider details

- **NPI number:** 1518929785
- **Authorized official:** MR. LARRY EUGENE THOMAS RPH (OWNER PHARMACIST)
- **Authorized official phone:** (601) 428-5977

## Contact information

- **Practice address:** 170 LEONTYNE PRICE BLVD, LAUREL, MS 39440-4428
- **Practice address phone:** (601) 428-5977
- **Practice address fax:** (601) 428-7150
- **Mailing address:** PO BOX 4111, LAUREL, MS 39441-4111
- **Mailing address phone:** (601) 428-5977
- **Mailing address fax:** (601) 428-7150

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 5123500001 | MS | — |
| 333600000X | Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 04/04/2006
- **Last updated:** 03/26/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330692 | — | MS |
| 05 | — | 01454526 | — | MS |