Organization
BAKERS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. EDWIN LAMAR BAKER JR. RPH (MANAGER, CHIEF PHARMACIST)
(601) 833-6361
Entity
Organization
Contact information
Practice address
212 N JACKSON ST, BROOKHAVEN, MS 39601-3040
(601) 833-6361
(601) 833-3125
Mailing address
PO BOX 236, BROOKHAVEN, MS 39602-0236
(601) 833-6361
(601) 833-3125
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
00104 01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030171
—
MS
Enumeration date
04/02/2007
Last updated
08/22/2020
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