Organization
SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC
Active
Other names
The Diabetic Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT SALMON RPH (PHARMACIST)
(662) 647-2591
Entity
Organization
Contact information
Practice address
1068 FACTORY DR, CHARLESTON, MS 38921-6620
(662) 647-6601
(662) 647-2411
Mailing address
1068 FACTORY DR, CHARLESTON, MS 38921-6620
(662) 647-6601
(662) 647-2411
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
056014
AR
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
06473/11.1
MS
332B00000X
Durable Medical Equipment & Medical Supplies
1022
AL
332B00000X
Durable Medical Equipment & Medical Supplies
8226997-1714
UT
332B00000X
Durable Medical Equipment & Medical Supplies
DME18182
ID
332B00000X
Durable Medical Equipment & Medical Supplies
MP00957
NV
332B00000X
Durable Medical Equipment & Medical Supplies
NPC-0003778
OR
332B00000X
Durable Medical Equipment & Medical Supplies
P013728
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00040385
—
MS
05
—
152800716
—
AK
05
—
175578701 175578702
—
TX
05
—
1757861
—
LA
01
—
4057054
BC TN
TN
Enumeration date
11/30/2005
Last updated
07/11/2019
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