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Organization
CLARKDALE PHARMACY AND GIFTS LLC
Active
Organization
CLARKDALE PHARMACY AND GIFTS LLC
Active
Other names
Clarkdale Pharmacy and Gifts
Organization subpart
No
Provider details
NPI number
Authorized official
DANIEL JOHNSON (OWNER)
(601) 938-5323
Entity
Organization
Contact information
Practice address
6935C HWY 145, MERIDIAN, MS 39301
(601) 553-0668
(601) 553-3048
Mailing address
6125 ZERO RD, MERIDIAN, MS 39301-8655
(601) 553-0668
(601) 553-3048
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
14215/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00873551
—
MS
01
—
2150263
PK
—
Enumeration date
02/13/2015
Last updated
07/06/2016
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