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Organization
SOUTHWEST DRUGSTORE OF MS INC
Active
Organization
SOUTHWEST DRUGSTORE OF MS INC
Active
Other names
SOUTHWEST DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
OSHER MOORE (OWNER)
(601) 898-7885
Entity
Organization
Contact information
Practice address
1601 ADELINE ST, HATTIESBURG, MS 39401-6267
(601) 582-2481
(601) 545-3662
Mailing address
1601 ADELINE ST, HATTIESBURG, MS 39401-6267
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
0077500
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0036251
—
MS
01
—
2500913
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
02/07/2007
Last updated
09/25/2007
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