# TARA PHARMACY SE LLC

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

## Provider details

- **NPI number:** 1821292731
- **Authorized official:** JAMES R. COX II PHARMD (VICE PRESIDENT)
- **Authorized official phone:** (601) 664-1664

## Contact information

- **Practice address:** 110 METROPLEX BLVD, SUITE H, PEARL, MS 39208
- **Practice address phone:** (601) 664-1664
- **Practice address fax:** (601) 664-1661
- **Mailing address:** P.O. BOX 428, 3690 SOUTHWESTERN BLVD, ORCHARD PARK, NY 14127-0428
- **Mailing address phone:** (716) 662-4955

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 06/13/2007
- **Last updated:** 02/25/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 01902360 | — | MS |