Organization
MEDI CENTER PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AUDRIC CHOW PHRM (OWNER)
(662) 624-6561
Entity
Organization
Contact information
Practice address
1629 N STATE ST, CLARKSDALE, MS 38614-6617
(662) 624-6561
(662) 627-2845
Mailing address
1629 N STATE ST, CLARKSDALE, MS 38614-6617
(662) 624-6561
(662) 624-6562
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
01632011
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00095109
—
MS
01
—
2511043
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
12/04/2006
Last updated
08/13/2007
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