Organization
LOGANS DISCOUNT DRUGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT LEE LOGAN SR. RPH (PHARMACIST OWNER)
(662) 983-7800
Entity
Organization
Contact information
Practice address
129 SOUTH NEWBERGER, BRUCE, MS 38915-0697
(662) 983-7800
(662) 983-7806
Mailing address
PO BOX 697, 129 SOUTH NEWBERGER, BRUCE, MS 38915-0697
(662) 983-7800
(662) 983-7806
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
01291011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00440635
MEDICAID DME #
MS
05
—
0330263
—
MS
Enumeration date
10/10/2006
Last updated
08/22/2020
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