# P & S PHARMACY, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** P AND S PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1619988128
- **Authorized official:** CLAYTON NAGLE (OWNER/PRESIDENT)
- **Authorized official phone:** (662) 746-1341

## Contact information

- **Practice address:** 804 GRAND AVE, YAZOO CITY, MS 39194-3234
- **Practice address phone:** (662) 746-1341
- **Practice address fax:** (662) 716-7123
- **Mailing address:** PO BOX 132, YAZOO CITY, MS 39194-0132

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 00741011 | MS | Yes |

## Other

- **Enumeration date:** 08/10/2006
- **Last updated:** 06/13/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0030049 | — | MS |
| 01 | — | 2507993 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |