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Organization
GULFPORT DISCOUNT DRUGS
Active
Organization
GULFPORT DISCOUNT DRUGS
Active
Other names
Gulfport Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE LARRY WILSON JR. PHARMD (PHARMACIST)
(228) 424-5579
Entity
Organization
Contact information
Practice address
1105 BROAD AVE, GULFPORT, MS 39501-2415
(228) 424-5579
Mailing address
13326 MARYS WAY, DIBERVILLE, MS 39540-6610
(228) 424-5579
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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