Organization
TLL&W INC DBA BUCKLEYS PHARMACY
Active
Other names
BUCKLEYS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CULLIE TAYLOR ROBERTS JR. R.PH. (PHARMACIST-OWNER)
(662) 843-3654
Entity
Organization
Contact information
Practice address
301 HOSPITAL DR, CLEVELAND, MS 38732-2358
(662) 843-3654
(662) 843-3622
Mailing address
301 HOSPITAL DR, CLEVELAND, MS 38732-2358
(662) 843-3654
(662) 843-3622
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
00509
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030389
—
MS
01
—
2515192
NCPDP
MS
Enumeration date
02/20/2007
Last updated
08/22/2020
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