Organization
30A INNOVATIONS,LLC
Active
Other names
Freedom Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MISS MICHELLE SCOGGIN (PHARMACIST/CO-OWNER)
(601) 422-7813
Entity
Organization
Contact information
Practice address
3902 HARDY ST, HATTIESBURG, MS 39402-1541
(601) 422-7813
Mailing address
PO BOX 16586, HATTIESBURG, MS 39404-6586
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
MS
Other
Enumeration date
09/02/2013
Last updated
09/02/2013
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