Organization
MS STATE DEPT OF HEALTH PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TRAVIS L REEVES RPH (ASST DIRECTOR)
(601) 713-3457
Entity
Organization
Contact information
Practice address
3156 LAWSON ST, JACKSON, MS 39213-5754
(601) 713-3457
(601) 364-2670
Mailing address
3156 LAWSON ST, JACKSON, MS 39213-5754
(601) 713-3457
(601) 364-2670
Taxonomy
Speciality
Code
Description
License number
State
251K00000X
Public Health or Welfare Agency
Primary
01085 05.1
MS
Other
Enumeration date
11/05/2008
Last updated
11/05/2008
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