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Organization

ATTALA DISCOUNT DRUGS

Active
Organization subpart
No

Provider details

NPI number
Authorized official
VICKIE ELLINGTON (PHARMACIST)
(662) 289-2312
Entity
Organization

Contact information

Practice address
337 HIGHWAY 12 W, KOSCIUSKO, MS 39090-3255
(662) 289-2312
(662) 289-2317
Mailing address
PO BOX 691, KOSCIUSKO, MS 39090-0691

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
E6737
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2508616
OTHER ID NUMBER COMMERCIAL NUMBER
Enumeration date
04/03/2007
Last updated
06/20/2008
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