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Organization
CONTROLEX ENTERPRISES, INC.
Active
Organization
CONTROLEX ENTERPRISES, INC.
Active
Other names
Palace Sav-Rex #638
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MODENA STARR CANNON (OPERATIONS MANAGER)
(228) 769-7067
Entity
Organization
Contact information
Practice address
641 DELMAS AVE, PASCAGOULA, MS 39567-4226
(228) 769-6362
Mailing address
1420 INGALLS AVE, PASCAGOULA, MS 39567-5650
(228) 769-7067
(228) 762-1756
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
05009/01.2
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330593
—
MS
01
—
2520434
NCPDP
MS
Enumeration date
03/16/2009
Last updated
03/16/2009
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