Organization
FUNDERBURKS PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHERYL M SUDDUTH R.PH. (PRESIDENT)
(662) 429-5337
Entity
Organization
Contact information
Practice address
134 W COMMERCE ST, HERNANDO, MS 38632-2240
(662) 429-5337
Mailing address
134 W COMMERCE ST, HERNANDO, MS 38632-2240
(662) 429-5337
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
00908/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030125
—
MS
05
—
00440498
—
MS
Enumeration date
03/11/2006
Last updated
03/24/2023
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