Organization
TAYLOR HARRIS DRUG STORE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MACK BENNIE HARRIS R.PH. (CO-OWNER PHARMACIST)
(228) 868-1036
Entity
Organization
Contact information
Practice address
1908 30TH AVE, GULFPORT, MS 39501-4534
(228) 868-1036
(228) 868-1355
Mailing address
1908 30TH AVE, GULFPORT, MS 39501-4534
(228) 868-1036
(228) 868-1355
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0090425
—
MS
Enumeration date
03/27/2007
Last updated
08/22/2020
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