Organization
SULLIVAN'S DISCOUNT DRUGS INC.
Active
Other names
Sullivan's Discount Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAVID CHARLES HUDSON R.PH. (PHARMACIST)
(662) 289-3234
Entity
Organization
Contact information
Practice address
109 NORTHSIDE SHOPPING CENTER, HWY 12 W, KOSCIUSKO, MS 39090
(662) 289-3234
(662) 289-3030
Mailing address
109 NORTHSIDE SHOPPING CENTER, HWY 12 W, KOSCIUSKO, MS 39090
(662) 289-3234
(662) 289-3030
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
00233
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
00233
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00034452
—
MS
01
—
2505026
NCPDP #
MS
Enumeration date
07/09/2006
Last updated
08/18/2021
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