Organization
MS STATE DEPT OF HEALTH
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIA WOODS (PHARMACIST)
(601) 713-3457
Entity
Organization
Contact information
Practice address
3156 LAWSON STREET, JACKSON, MS 39213
(601) 713-3457
(601) 364-2670
Mailing address
3156 LAWSON STREET, JACKSON, MS 39213
(601) 713-3457
(601) 364-2670
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
01085 05.1
MS
3336C0002X
Clinic Pharmacy
0108505.1
MS
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2517196
NCPDP
—
Enumeration date
12/18/2006
Last updated
10/22/2024
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