Individual
MR. WILLIAM E. BRENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
984 MAIN ST, SOUTHAVEN, MS 38671-1509
(662) 342-1915
(662) 393-4021
Mailing address
984 MAIN ST, SOUTHAVEN, MS 38671-1509
(662) 342-1915
(662) 393-4021
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
10915
TN
183500000X
Pharmacist
Primary
E-07333
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000010915
STATE OF TENNESSEE DEPARTMENT OF HEALTH, PHARMACIST LICENSE NUMBER
TN
01
—
E-07333
MISSISSIPPI PHARMACY LICENSE NUMBER
MS
Enumeration date
03/31/2011
Last updated
03/31/2011
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