Organization
IUKA PHARMACY SERVICES LLC
Active
Other names
Iuka Discount Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY LEE GRIFFIN PHARMD (OWNER)
(662) 423-9039
Entity
Organization
Contact information
Practice address
1411 W QUITMAN ST, IUKA, MS 38852-1130
(662) 423-9039
(662) 423-9318
Mailing address
1411 W QUITMAN ST, IUKA, MS 38852-1130
(662) 423-9039
(662) 423-9318
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
00827011
MS
333600000X
Pharmacy
00827011
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00092754
—
MS
01
—
04158389
DME MEDICAID
MS
Enumeration date
07/19/2006
Last updated
09/10/2021
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