# VAN DEV ENTERPRISES INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** MCDANIEL PHARMACY
- **Organization subpart:** No

## Provider details

- **NPI number:** 1932204880
- **Authorized official:** DAPHYNE VANDEVENDER PD (OWNER)
- **Authorized official phone:** (601) 437-5121

## Contact information

- **Practice address:** 1005 MARKET ST, PORT GIBSON, MS 39150-2337
- **Practice address phone:** (601) 437-5121
- **Practice address fax:** (601) 437-5102
- **Mailing address:** PO BOX 1024, PORT GIBSON, MS 39150-1024
- **Mailing address phone:** (601) 437-5121
- **Mailing address fax:** (601) 437-5102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 00680 | MS | Yes |

## Other

- **Enumeration date:** 09/14/2006
- **Last updated:** 02/25/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0330665 | — | MS |
| 01 | — | 2506737 | NCPDP PROVIDER IDENTIFICATION NUMBER | — |