Organization
WILSON'S PHARMACY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SIMON P. WILSON III R.PH. (CO-OWNER)
(601) 928-4446
Entity
Organization
Contact information
Practice address
101 PINE AVE E, WIGGINS, MS 39577-2752
(601) 928-4446
(601) 928-4844
Mailing address
101 PINE AVE E, WIGGINS, MS 39577-2752
(601) 928-4446
(601) 928-4844
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
00469/01.1
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00035157
—
MS
05
—
02028875
—
MS
Enumeration date
10/13/2006
Last updated
02/05/2019
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