Organization
CITY DRUGS OF CRYSTAL SPRINGS, INC.
Active
Other names
City Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
MR. REAGAN L BROWN RPH (PHARMACIST)
(601) 892-4121
Entity
Organization
Contact information
Practice address
113 BO BO DR, CRYSTAL SPRINGS, MS 39059-2741
(601) 892-4121
(601) 892-1598
Mailing address
113 BO BO DR, CRYSTAL SPRINGS, MS 39059-2741
(601) 892-4121
(601) 892-1598
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
01756/01.1
MS
3336L0003X
Long Term Care Pharmacy
01756/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030165
—
MS
01
—
2501624
NCPDP NUMBER
MS
Enumeration date
02/23/2006
Last updated
08/10/2016
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