Organization
TUNICA PHARMACY, INC.
Active
Other names
TUNICA PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM ERIC POFF R.PH. (OWNER PRESIDENT)
(901) 826-6493
Entity
Organization
Contact information
Practice address
1337 HIGHWAY 61 N, TUNICA, MS 38676-9661
(662) 363-1431
(662) 363-9966
Mailing address
PO BOX 1724, TUNICA, MS 38676-1724
(662) 363-1431
(663) 363-9966
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00653
MS
3336S0011X
Specialty Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000034711
—
MS
05
—
00034711
—
MS
01
—
2043432
PK
—
Enumeration date
10/13/2006
Last updated
10/16/2023
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