Organization
MACON CITY DRUG STORE, INC.
Active
Other names
CITY DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MEGAN F JOHNSON (MANAGER)
(662) 726-5143
Entity
Organization
Contact information
Practice address
3281 JEFFERSON ST, MACON, MS 39341-2279
(662) 726-5143
(662) 726-5183
Mailing address
PO BOX 424, MACON, MS 39341-0424
(662) 726-5143
(662) 726-5183
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00125011
MS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00039888
—
MS
05
—
00440507
—
MS
01
—
2043292
PK
—
Enumeration date
07/09/2006
Last updated
01/26/2024
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