Individual
MRS. JOHNENE WEST THAMES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
116 SECOND ST S, WIGGINS, MS 39577-2758
(601) 928-3215
(601) 928-6072
Mailing address
116 SECOND ST S, WIGGINS, MS 39577-2758
(601) 928-3215
(601) 928-6072
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E6607
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E6607
PHARMACIST LICENSE
MS
Enumeration date
09/28/2010
Last updated
09/28/2010
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