Organization
PHARMACY MANAGEMENT GROUP
Active
Other names
TOTAL CARE PHARMACY OF TUPELO
Organization subpart
No
Provider details
NPI number
Authorized official
RON HARRIS (CEO MANG MEMBER)
(662) 327-4025
Entity
Organization
Contact information
Practice address
2590 W MAIN ST, TUPELO, MS 38801-3150
(662) 407-0123
(662) 407-0124
Mailing address
101 12TH ST S, COLUMBUS, MS 39701-5830
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
—
—
3336C0004X
Compounding Pharmacy
Primary
07473012
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2587004
OTHER ID NUMBER
—
Enumeration date
10/02/2007
Last updated
10/11/2007
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