# TYSON DRUGS INC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760880637
- **Authorized official:** MR. ROBERT H LOMENICK RPH (PRESIDENT)
- **Authorized official phone:** (662) 252-2321

## Contact information

- **Practice address:** 145 E VAN DORN AVE, HOLLY SPRINGS, MS 38635-3025
- **Practice address phone:** (662) 252-2321
- **Practice address fax:** (662) 252-1656
- **Mailing address:** 145 E VAN DORN AVE, HOLLY SPRINGS, MS 38635-3025
- **Mailing address phone:** (662) 252-2321
- **Mailing address fax:** (662) 252-1656

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | F0500 | MS | Yes |

## Other

- **Enumeration date:** 12/09/2014
- **Last updated:** 01/07/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2590013 | NCPDP | — |
| 01 | — | F0500 | PHARMACY | MS |