Organization
BRENTS DRUGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RANDY CALVERT (PRESIDENT)
(601) 366-1012
Entity
Organization
Contact information
Practice address
655 DULING AVE, JACKSON, MS 39216-4008
(601) 366-3428
(601) 366-0263
Mailing address
655 DULING AVE, JACKSON, MS 39216-4008
(601) 366-1012
(601) 366-0263
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
00743011
MS
3336C0003X
Community/Retail Pharmacy
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0035394
—
MS
01
—
2504555
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
11/08/2006
Last updated
12/14/2007
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