Organization
SPECIALTY PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAM MCLEOD (OWNER)
(601) 362-6888
Entity
Organization
Contact information
Practice address
1000 LAKELAND SQUARE EXT, SUITE 100, FLOWOOD, MS 39232-7620
(601) 362-6888
(601) 362-7744
Mailing address
1000 LAKELAND SQUARE EXT, SUITE 100, FLOWOOD, MS 39232-7620
(601) 362-6888
(601) 362-7744
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
04095/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2519215
NABP
MS
Enumeration date
05/23/2014
Last updated
05/28/2014
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