Organization
COLONIAL DISCOUNT DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. J. RICHARD THOMAS R. PH. (PHAMACIST/MANAGER)
(601) 638-5521
Entity
Organization
Contact information
Practice address
1017 MISSION 66, VICKSBURG, MS 39183-2753
(601) 638-5521
(601) 638-5522
Mailing address
1017 MISSION 66, VICKSBURG, MS 39183-2753
(601) 638-5521
(601) 638-5522
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E7063
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030232
—
MS
01
—
2507587
NABP/NCPDP
MS
Enumeration date
07/09/2006
Last updated
12/14/2010
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