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Organization

VILLIAGE PHARMACY INC

Active
Other names
VILLAGE PHARMACY INC
Organization subpart
No

Provider details

NPI number
Authorized official
CASEY PERRY (MANAGER)
(662) 873-9020
Entity
Organization

Contact information

Practice address
48 S FOURTH ST, ROLLING FORK, MS 39159-5147
(662) 873-9020
(662) 873-9080
Mailing address
48 S FOURTH ST, ROLLING FORK, MS 39159-5147

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
03144/01.1
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00330208
MS
01
2518465
NCPDP PROVIDER IDENTIFICATION NUMBER
Enumeration date
10/12/2005
Last updated
11/20/2009
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