Organization
FAMILY DRUG MART OF POPLARVILLE,LLC
Active
Other names
FAMILY DRUG MART OF POPLARVILLE
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSE MIGUEL YANEZ RPH (OWNER/PHARMACIST)
(504) 338-7992
Entity
Organization
Contact information
Practice address
100 HIGHWAY 11 N, POPLARVILLE, MS 39470-2217
(504) 338-7992
(985) 727-7494
Mailing address
2299 SUNSET BLVD, SLIDELL, LA 70461-5605
(504) 338-7992
(985) 727-7494
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
17206
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9030801
—
MS
Enumeration date
08/09/2018
Last updated
12/24/2021
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