# CONTROLEX ENTERPRISES, INC.

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Palace Sav-Rex \#638
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912148362
- **Authorized official:** MRS. MODENA STARR CANNON (OPERATIONS MANAGER)
- **Authorized official phone:** (228) 769-7067

## Contact information

- **Practice address:** 641 DELMAS AVE, PASCAGOULA, MS 39567-4226
- **Practice address phone:** (228) 769-6362
- **Mailing address:** 1420 INGALLS AVE, PASCAGOULA, MS 39567-5650
- **Mailing address phone:** (228) 769-7067
- **Mailing address fax:** (228) 762-1756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 05009/01.2 | NULL | Yes |

## Other

- **Enumeration date:** 03/16/2009
- **Last updated:** 03/16/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00330593 | — | MS |
| 01 | — | 2520434 | NCPDP | MS |