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Organization
VAN DEV ENTERPRISES INC
Active
Organization
VAN DEV ENTERPRISES INC
Active
Other names
MCDANIEL PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
DAPHYNE VANDEVENDER PD (OWNER)
(601) 437-5121
Entity
Organization
Contact information
Practice address
1005 MARKET ST, PORT GIBSON, MS 39150-2337
(601) 437-5121
(601) 437-5102
Mailing address
PO BOX 1024, PORT GIBSON, MS 39150-1024
(601) 437-5121
(601) 437-5102
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
00680
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330665
—
MS
01
—
2506737
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/14/2006
Last updated
02/25/2010
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