# MICHAEL L ATKEISON

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- **Entity:** Organization
- **Status:** Active
- **Other names:** ECRU DISCOUNT PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1770702953
- **Authorized official:** MICHAEL ATKEISON RPH (OWNER AND RPH)
- **Authorized official phone:** (662) 489-8084

## Contact information

- **Practice address:** 186 MAIN ST, ECRU, MS 38841-9432
- **Practice address phone:** (662) 489-8080
- **Practice address fax:** (662) 489-8484
- **Mailing address:** PO BOX 397, ECRU, MS 38841-0397
- **Mailing address phone:** (662) 489-8084

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | F02094 | MS | Yes |

## Other

- **Enumeration date:** 04/25/2007
- **Last updated:** 08/08/2013

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00030506 | — | MS |
| 01 | — | 2045119 | PK | — |