Organization
PEARL RIVER DRUG CO.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANDREW L FAILLA RPH (OWNER/PRESIDENT)
(601) 798-4846
Entity
Organization
Contact information
Practice address
510 S MAIN ST, POPLARVILLE, MS 39470
(601) 795-4239
(601) 795-4941
Mailing address
PO BOX 10, PO BOX 10, PICAYUNE, MS 39466
(601) 795-4239
(601) 795-4941
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
00558/01.1
MS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00033553
—
MS
Enumeration date
07/25/2006
Last updated
05/01/2025
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