Organization
MEDCENTER DISCOUNT PHARMACY INC
Active
Other names
MEDCENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN STYRON RPH (PRESIDENT)
(601) 849-3393
Entity
Organization
Contact information
Practice address
360 SIMPSON HIGHWAY 149 STE 100, MAGEE, MS 39111-3840
(601) 849-3393
(601) 849-3808
Mailing address
360 SIMPSON HIGHWAY 149 STE 100, MAGEE, MS 39111-3840
(601) 849-3393
(601) 849-3808
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
02149
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030079
—
MS
01
—
2045189
PK
—
Enumeration date
08/18/2006
Last updated
12/18/2016
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