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Organization
SHELBY DRUG CO INC HWY 61 SOUTH
Active
Organization
SHELBY DRUG CO INC HWY 61 SOUTH
Active
Other names
HAIRE DRUG CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE ELLIS RPH (OWNER)
(662) 624-2526
Entity
Organization
Contact information
Practice address
549 MEDICAL DR, CLARKSDALE, MS 38614-6733
(662) 624-2526
(662) 624-2527
Mailing address
549 MEDICAL DR, CLARKSDALE, MS 38614-6733
(662) 624-2526
(662) 624-2527
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
01807011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2513934
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/11/2006
Last updated
01/25/2011
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