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Organization
CONTROLEX ENTRPRISES, INC
Active
Organization
CONTROLEX ENTRPRISES, INC
Active
Other names
GULF COAST SAV-REX #631
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MODENA S CANNON (PHARMACY OPERATIONS MANAGER)
(228) 769-7067
Entity
Organization
Contact information
Practice address
1420 INGALLS AVE, PASCAGOULA, MS 39567-5650
(228) 762-4622
(228) 762-1756
Mailing address
PO BOX 2070, PASCAGOULA, MS 39569-2070
(228) 762-4622
(228) 762-1756
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
01128/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0032191
—
MS
01
—
2506369
NCPDP
MS
Enumeration date
10/19/2006
Last updated
10/01/2010
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