Organization
DIAMOND GROVE CTR PHARMACY
Active
Other names
DIAMOND GROVE CENTER PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
PATRICK SWOOPES PHARMD (CEO)
(662) 779-0119
Entity
Organization
Contact information
Practice address
2311 HIGHWAY 15 S, LOUISVILLE, MS 39339-7071
(662) 779-0119
(662) 779-0126
Mailing address
2311 HIGHWAY 15 S, LOUISVILLE, MS 39339-7071
(662) 779-0119
(662) 779-0126
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
03665
MS
3336I0012X
Institutional Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330450
—
MS
01
—
2047294
PK
—
Enumeration date
08/10/2006
Last updated
07/15/2016
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