Organization
OAK GROVE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN STEPHENS (PHARMACIST)
(601) 264-1198
Entity
Organization
Contact information
Practice address
5039 OLD HIGHWAY 11, SUITE# 1, HATTIESBURG, MS 39402-8845
(601) 264-1198
(601) 264-1106
Mailing address
5039 OLD HIGHWAY 11, SUITE# 1, HATTIESBURG, MS 39402-8845
(601) 264-1198
(601) 264-1106
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
07555
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030315
—
MS
Enumeration date
11/14/2006
Last updated
08/22/2020
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