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Organization
THRIVE RX LLC
Active
Organization
THRIVE RX LLC
Active
Other names
ThriveRx
Organization subpart
No
Provider details
NPI number
Authorized official
CLARK LEVI (OWNER)
(228) 218-5667
Entity
Organization
Contact information
Practice address
6440 U S HIGHWAY 98, HATTIESBURG, MS 39402-8437
(601) 852-1099
(601) 851-0188
Mailing address
6440 U S HIGHWAY 98, HATTIESBURG, MS 39402-8437
(601) 852-1099
(601) 851-0188
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
14941/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2164326
PK
—
Enumeration date
09/28/2016
Last updated
03/06/2017
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