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Organization
ASM INC
Active
Organization
ASM INC
Active
Other names
Mike's Pharmacy, A Memeber of the Medicine Shoppe Family
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE KLEPZIG (PHARMACIST IN CHARGE)
(662) 892-8448
Entity
Organization
Contact information
Practice address
9065 SANDIDGE CENTER CV, SUITE A, OLIVE BRANCH, MS 38654-3574
(662) 892-8448
(662) 892-8189
Mailing address
9065 SANDIDGE CENTER CV, SUITE A, OLIVE BRANCH, MS 38654-3574
(662) 892-8448
(662) 892-8189
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
14901/1.1
MS
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0040940
—
MS
01
—
2162413
PK
—
Enumeration date
08/02/2016
Last updated
12/01/2016
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