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Organization
MISSISSIPPI DISCOUNT DRUGS OF CLINTON INC
Active
Organization
MISSISSIPPI DISCOUNT DRUGS OF CLINTON INC
Active
Other names
MISSISSIPPI DISCOUNT DRUGS HEALTH MART
Organization subpart
No
Provider details
NPI number
Authorized official
CARY PARKS ACCOUNTING (GENERAL MGR AND OWNER)
(601) 924-5212
Entity
Organization
Contact information
Practice address
224 CLINTON BLVD, CLINTON, MS 39056-5126
(601) 924-5212
(601) 924-4649
Mailing address
224 CLINTON BLVD, CLINTON, MS 39056-5126
(601) 924-5212
(601) 924-4649
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
00837/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330602
—
MS
01
—
2501561
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
07/02/2005
Last updated
08/02/2011
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