Organization
GRIFFIN'S DISCOUNT PHARMACY INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KEN R FULLILOVE JR. (CO-OWNER)
(662) 456-2501
Entity
Organization
Contact information
Practice address
339 E MADISON ST, HOUSTON, MS 38851-2322
(662) 456-2501
(662) 456-4052
Mailing address
339 E MADISON ST, HOUSTON, MS 38851-2322
(662) 456-2501
(662) 456-4052
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
01477
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030446
—
MS
01
—
01477
PHARMACY PERMIT
MS
01
—
2511954
NCPDP
—
Enumeration date
10/04/2006
Last updated
08/22/2020
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