# MACON CITY DRUG STORE, INC.

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Parent organization:** MACON CITY DRUG STORE, INC.
- **Other names:** Brooksville Drug Store
- **Organization subpart:** Yes

## Provider details

- **NPI number:** 1639211121
- **Legal business name:** MACON CITY DRUG STORE, INC.
- **Authorized official:** MR. WILLIAM J BELL JR. (OWNER)
- **Authorized official phone:** (662) 738-5041

## Contact information

- **Practice address:** 1556 N OLIVER ST, BROOKSVILLE, MS 39739-4003
- **Practice address phone:** (662) 738-5041
- **Practice address fax:** (662) 738-5043
- **Mailing address:** PO BOX 312, BROOKSVILLE, MS 39739-0312
- **Mailing address phone:** (662) 738-5041
- **Mailing address fax:** (662) 738-5043

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 06158 | MS | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 05/12/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 06689871 | — | MS |