Organization
NORTHEAST PHARMACEUTICALS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL L MIMS (DIRECTOR OF OPERATIONS)
(334) 356-7627
Entity
Organization
Contact information
Practice address
608 MARQUETTE ROAD, BRANDON, MS 39042
(334) 356-7627
(334) 356-8347
Mailing address
608 MARQUETTE RD, BRANDON, MS 39042
(334) 356-7627
(334) 356-8347
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
09098
MS
Other
Enumeration date
08/03/2011
Last updated
08/05/2011
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