Organization
WESTGATE DRUGS INC
Active
Other names
WESTGATE DRUGS INC
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE ELLIS RPH (OWNER/PHARMACIST)
(662) 627-7857
Entity
Organization
Contact information
Practice address
1015 LEE DR, SUITE 11, CLARKSDALE, MS 38614-3698
(662) 627-7857
(662) 627-7225
Mailing address
1015 LEE DR, SUITE 11, CLARKSDALE, MS 38614-3698
(662) 627-7857
(662) 627-7225
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00415/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00035351
—
MS
01
—
2050540
PK
—
Enumeration date
12/26/2006
Last updated
09/14/2016
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