Organization
FIRST PHARMACY SERVICES 5
Active
Other names
FIRST PHARMACY SERVICES #5
Organization subpart
No
Provider details
NPI number
Authorized official
DENISE PRATT (VICE PRESIDENT)
(662) 349-3300
Entity
Organization
Contact information
Practice address
6888 GOODMAN RD STE 122, OLIVE BRANCH, MS 38654-8761
(662) 349-3300
(662) 349-3311
Mailing address
PO BOX 47, POPE, MS 38658-0047
(662) 349-3300
(662) 349-3311
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
13864/4.1
MS
3336M0003X
Managed Care Organization Pharmacy
—
—
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2149277
PK
—
Enumeration date
06/16/2011
Last updated
04/05/2022
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