# MEDICAL PLAZA ON HARPER LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MEDICAL PLAZA ON HARPER
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801176144
- **Authorized official:** JESSE BART DORAN (PHARMACIST IN CHARGE)
- **Authorized official phone:** (662) 286-6337

## Contact information

- **Practice address:** 1425 S. HARPER ROAD, CORINTH, MS 38834
- **Practice address phone:** (662) 286-6337
- **Practice address fax:** (662) 396-6333
- **Mailing address:** 1425 S. HARPER ROAD, CORINTH, MS 38834
- **Mailing address phone:** (662) 286-6337
- **Mailing address fax:** (662) 396-6333

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 08781/01.1 | MS | Yes |

## Other

- **Enumeration date:** 08/18/2011
- **Last updated:** 09/02/2015

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00529591 | — | MS |
| 01 | — | 2588412 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |