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Organization
LONG BEACH DRUGS LLC
Active
Organization
LONG BEACH DRUGS LLC
Active
Other names
Long Beach Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREL MALLEY (OWNER/PHARM)
(228) 822-9868
Entity
Organization
Contact information
Practice address
5107 BEATLINE RD, SUITE 100, LONG BEACH, MS 39560-3871
(228) 822-9868
(228) 822-2312
Mailing address
5107 BEATLINE RD, SUITE 100, LONG BEACH, MS 39560-3871
(228) 822-9868
(228) 822-2312
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
06270
MS
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04689397
—
MS
01
—
2521854
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
10/07/2006
Last updated
03/07/2013
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