Organization
NORTHTOWN PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANDREW CLARK PHARM. D (CEO/FOUNDER)
(601) 665-4694
Entity
Organization
Contact information
Practice address
6220 OLD CANTON RD, JACKSON, MS 39211-2924
(601) 665-4694
(769) 333-9173
Mailing address
6220 OLD CANTON RD, JACKSON, MS 39211-2924
(601) 665-4694
(769) 333-9173
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
12/08/2020
Last updated
07/07/2021
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