# MISSISSIPPI DISCOUNT DRUGS OF CLINTON INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MISSISSIPPI DISCOUNT DRUGS HEALTH MART
- **Organization subpart:** No

## Provider details

- **NPI number:** 1730186982
- **Authorized official:** CARY PARKS ACCOUNTING (GENERAL MGR AND OWNER)
- **Authorized official phone:** (601) 924-5212

## Contact information

- **Practice address:** 224 CLINTON BLVD, CLINTON, MS 39056-5126
- **Practice address phone:** (601) 924-5212
- **Practice address fax:** (601) 924-4649
- **Mailing address:** 224 CLINTON BLVD, CLINTON, MS 39056-5126
- **Mailing address phone:** (601) 924-5212
- **Mailing address fax:** (601) 924-4649

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 00837/01.1 | MS | Yes |

## Other

- **Enumeration date:** 07/02/2005
- **Last updated:** 08/02/2011

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0330602 | — | MS |
| 01 | — | 2501561 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |