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Individual

MICHAEL HENRY ROSE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
218 CALDWELL DR, HAZLEHURST, MS 39083-2712
(601) 894-1222
(601) 894-1522
Mailing address
1020 MELANIE LN, HAZLEHURST, MS 39083-9496
(601) 892-2546

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-6145
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0030881
MS
Enumeration date
05/01/2007
Last updated
07/08/2007
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