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Organization
MCM OF MISSISSIPPI LLC
Active
Organization
MCM OF MISSISSIPPI LLC
Active
Other names
houston family pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER CARTER (OWNER)
(662) 542-8464
Entity
Organization
Contact information
Practice address
339 E MADISON ST, HOUSTON, MS 38851-2322
(662) 631-5055
(662) 631-5097
Mailing address
339 E MADISON ST, HOUSTON, MS 38851-2322
(662) 542-8464
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
14900/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08372765
—
MS
01
—
2163837
PK
—
Enumeration date
08/24/2016
Last updated
01/09/2020
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