Organization
CCMS PHARMACY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SAMUEL MAHFOUZ (MANAGER)
(318) 443-9195
Entity
Organization
Contact information
Practice address
110 METROPLEX BLVD STE H, PEARL, MS 39208-9210
(601) 664-1664
(601) 664-1661
Mailing address
1412 CENTRE CT STE 503, ALEXANDRIA, LA 71301-3400
(318) 443-9195
(318) 698-0007
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
Primary
—
—
Other
Enumeration date
01/08/2026
Last updated
01/08/2026
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