Organization
GATLINS PHARMACY INC
Active
Other names
GATLINS PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE DORAN (OWNER)
(662) 438-6605
Entity
Organization
Contact information
Practice address
18 FIRST AVE, TISHOMINGO, MS 38873-8441
(662) 438-6605
(662) 438-6680
Mailing address
PO BOX 369, TISHOMINGO, MS 38873-0369
(662) 438-6605
(662) 438-6680
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00799011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00039276
—
MS
01
—
2043431
PK
—
Enumeration date
09/27/2006
Last updated
07/19/2018
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