Organization
ROLLING FORK DRUG CO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GUY M PHILLIPS RPH. (OWNER/PRESIDENT)
(662) 207-0616
Entity
Organization
Contact information
Practice address
20917 HIGHWAY 61, ROLLING FORK, MS 39159-5027
(662) 873-4723
(662) 873-4002
Mailing address
903 HIGHWAY 82 E BLDG G, INDIANOLA, MS 38751-2325
(662) 887-4135
(662) 887-9703
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Enumeration date
08/23/2019
Last updated
12/19/2019
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