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Organization
MOSBYS DRUG STORE
Active
Organization
MOSBYS DRUG STORE
Active
Other names
Mosby's Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL MURPHY ACCOUNTANT (MEMBER/OWNER)
(601) 859-3939
Entity
Organization
Contact information
Practice address
1301 E PEACE ST, CANTON, MS 39046-4937
(601) 859-4212
(601) 859-4260
Mailing address
195 EAST PEACE STREET, CANTON, MS 39046
(601) 859-3939
(601) 855-2133
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
NULL
333600000X
Pharmacy
—
NULL
3336C0003X
Community/Retail Pharmacy
Primary
00235/1.1
MS
3336L0003X
Long Term Care Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000033316
—
MS
01
—
2157850
PK
—
Enumeration date
10/13/2006
Last updated
11/03/2019
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