Organization
GENTEX PHARMA
Active
Other names
Gentex Pharma LLC
Organization subpart
No
Provider details
NPI number
Authorized official
FORD JENNINGS MUNDY PERSON IN CHARGE (OWNER)
(870) 243-1687
Entity
Organization
Contact information
Practice address
121 MARKETRIDGE DR, SUITE C, RIDGELAND, MS 39157-6027
(601) 990-9497
(601) 510-9318
Mailing address
121 MARKETRIDGE DR, SUITE C, RIDGELAND, MS 39157-6027
(601) 990-9497
(601) 510-9318
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
06677/6.1
MS
Other
Enumeration date
05/04/2016
Last updated
05/04/2016
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