# CONTROLEX ENTRPRISES, INC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** GULF COAST SAV-REX \#631
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972685097
- **Authorized official:** MS. MODENA S CANNON (PHARMACY OPERATIONS MANAGER)
- **Authorized official phone:** (228) 769-7067

## Contact information

- **Practice address:** 1420 INGALLS AVE, PASCAGOULA, MS 39567-5650
- **Practice address phone:** (228) 762-4622
- **Practice address fax:** (228) 762-1756
- **Mailing address:** PO BOX 2070, PASCAGOULA, MS 39569-2070
- **Mailing address phone:** (228) 762-4622
- **Mailing address fax:** (228) 762-1756

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 01128/01.2 | MS | Yes |

## Other

- **Enumeration date:** 10/19/2006
- **Last updated:** 10/01/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0032191 | — | MS |
| 01 | — | 2506369 | NCPDP | MS |