Organization
MIDSOUTH MEDICAL SPECIALTIES, LLC
Active
Other names
National Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN O'BANNON RPH (CEO)
(662) 449-7876
Entity
Organization
Contact information
Practice address
1534 MALVERN AVE, HOT SPRINGS, AR 71901-6508
(501) 623-2280
Mailing address
185 W CENTER ST, HERNANDO, MS 38632-2268
(662) 449-7876
(662) 449-7970
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR15732
AR
Other
Enumeration date
04/04/2017
Last updated
04/04/2017
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