Organization
CITY DRUG STORE,INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THOMAS HASSETT (OWNER)
(662) 827-5561
Entity
Organization
Contact information
Practice address
100 W. WASHINGTON ST, HOLLANDALE, MS 38748-0426
(662) 827-5561
Mailing address
P. O. BOX 426, HOLLANDALE, MS 38748-0426
(662) 827-5561
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
00115/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030902
—
MS
01
—
2504290
NABP
MS
Enumeration date
10/02/2006
Last updated
09/19/2023
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