Organization
BORROUMS REXALL DRUG STORE INC
Active
Other names
Borroum's Drug Store Inc.
Organization subpart
No
Provider details
NPI number
Authorized official
CAMILLE MITCHELL (PRESIDENT)
(662) 286-3361
Entity
Organization
Contact information
Practice address
604 E WALDRON ST, CORINTH, MS 38834-4863
(662) 286-3361
(662) 286-3362
Mailing address
604 E WALDRON ST, CORINTH, MS 38834-4863
(662) 286-3361
(662) 286-3362
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00202/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030473
—
MS
01
—
2123758
PK
—
Enumeration date
02/12/2010
Last updated
03/01/2017
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