Organization
CHANEYS PHARMACY OF GRENADA INC
Active
Other names
DYRE KENT DRUG CO
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES MOORE (MANAGER)
(662) 226-5232
Entity
Organization
Contact information
Practice address
109 1ST ST, GRENADA, MS 38901-2615
(662) 226-5232
(662) 226-5252
Mailing address
PO BOX 100, GRENADA, MS 38902-0100
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
00229010
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00159098
—
MS
05
—
00330676
—
MS
01
—
2503729
OTHER ID NUMBER
—
Enumeration date
09/14/2006
Last updated
12/06/2007
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