# SOUTHWEST DRUGSTORE OF MS INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** SOUTHWEST DRUG STORE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1750421293
- **Authorized official:** OSHER MOORE (OWNER)
- **Authorized official phone:** (601) 898-7885

## Contact information

- **Practice address:** 1601 ADELINE ST, HATTIESBURG, MS 39401-6267
- **Practice address phone:** (601) 582-2481
- **Practice address fax:** (601) 545-3662
- **Mailing address:** 1601 ADELINE ST, HATTIESBURG, MS 39401-6267

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 0077500 | MS | Yes |

## Other

- **Enumeration date:** 02/07/2007
- **Last updated:** 09/25/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0036251 | — | MS |
| 01 | — | 2500913 | OTHER ID NUMBER-COMMERCIAL NUMBER | — |