Organization
N.M.R.C. PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JASON IVY (BUSINESS DIRECTOR)
(662) 513-7690
Entity
Organization
Contact information
Practice address
967 REGIONAL CENTER DR, OXFORD, MS 38655
(662) 234-1476
(662) 234-1699
Mailing address
967 REGIONAL CENTER DR, OXFORD, MS 38655-3551
(662) 234-1476
(662) 234-1699
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
00959/03.1
MS
3336L0003X
Long Term Care Pharmacy
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030418
—
MS
01
—
25-19188
NABP
MS
Enumeration date
08/26/2005
Last updated
06/14/2018
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