Organization
MADISON DISCOUNT DRUGS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DENNIS R REVES (PRESIDENT)
(601) 856-7111
Entity
Organization
Contact information
Practice address
980-A HIGHWAY 51, MADISON, MS 39110
(601) 856-7111
(601) 856-1735
Mailing address
PO BOX 1606, MADISON, MS 39130
(601) 856-7111
(601) 856-1735
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
002244
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030159
—
MS
01
—
2516891
NABP
MS
Enumeration date
10/03/2006
Last updated
11/20/2007
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