Organization
CITY DRUG, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
REAGAN LINDSAY BROWN RPH (MEMBER)
(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
PO BOX 193, CRYSTAL SPRINGS, MS 39059-0193
(601) 892-4121
(601) 892-1598
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030165
—
MS
Enumeration date
10/17/2018
Last updated
02/27/2019
Update your record
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