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Organization

ESSCO DISCOUNT DRUG CENTER INC

Active
Other names
ESSCO DISCOUNT DRUG CENTER
Organization subpart
No

Provider details

NPI number
Authorized official
MAX SANDERS (PRESIDENT)
(662) 746-7423
Entity
Organization

Contact information

Practice address
732 E FIFTEENTH ST, YAZOO CITY, MS 39194-2706
(662) 746-7423
(662) 746-8158
Mailing address
732 E FIFTEENTH ST, YAZOO CITY, MS 39194-2706
(662) 746-7423
(662) 746-8158

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
01409
MS
3336L0003X
Long Term Care Pharmacy
3336S0011X
Specialty Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0030034
MS
01
2507955
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
10/07/2006
Last updated
08/24/2011
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