Organization
CLINT'S PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CLINT EUGENE BANE III (OWNER/PHARMACIST)
(601) 833-3160
Entity
Organization
Contact information
Practice address
515 BROOKWAY BLVD, BROOKHAVEN, MS 39601-3266
(601) 833-3160
Mailing address
515 BROOKWAY BLVD, BROOKHAVEN, MS 39601-3266
(601) 833-3160
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
3336C0003X
MS
Other
Enumeration date
03/16/2010
Last updated
03/16/2010
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