Organization
DECATUR DRUGS INC
Active
Other names
Wheeler Drug Store
Organization subpart
No
Provider details
NPI number
Authorized official
CHARLES AUSTIN BOGGAN RPH (OWNER)
(601) 635-2646
Entity
Organization
Contact information
Practice address
95 W BROAD ST, DECATUR, MS 39327-8959
(601) 635-2646
(601) 635-4039
Mailing address
PO BOX 98, DECATUR, MS 39327-0098
(601) 635-2646
(601) 635-4039
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
E-6485
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030493
—
MS
Enumeration date
12/18/2006
Last updated
04/04/2019
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