Organization
HOLLIS DISCOUNT PHARMACY, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIMMY L TUCKER RPH (CEO/PRESIDENT)
(662) 837-7323
Entity
Organization
Contact information
Practice address
1008 CITY AVE N, RIPLEY, MS 38663-1413
(662) 837-4774
Mailing address
1008 CITY AVE N, RIPLEY, MS 38663-1413
(662) 837-4774
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
MS1326
MS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00095087
—
MS
Enumeration date
12/20/2006
Last updated
04/16/2023
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