Organization
AZALEA PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JEFFREY WAYNE ROLLINS (CFO)
(228) 334-2411
Entity
Organization
Contact information
Practice address
1019 GOVERNMENT ST, SUITE F, OCEAN SPRINGS, MS 39564-3860
(228) 818-5111
(228) 818-5113
Mailing address
1801 GOVERNMENT ST, SUITE C, OCEAN SPRINGS, MS 39564-3942
(228) 818-5111
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
12664/1.1
MS
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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