Organization
MIDSOUTH MEDICAL SPECIALTIES, LLC
Active
Organization
MIDSOUTH MEDICAL SPECIALTIES, LLC
Active
Other names
Oak Park Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
EDWIN O'BANNON RPH (CEO)
(662) 449-7876
Entity
Organization
Contact information
Practice address
105 SAWTOOTH OAK ST, HOT SPRINGS, AR 71901-7160
(501) 623-2222
Mailing address
185 W CENTER ST, HERNANDO, MS 38632-2268
(662) 449-7876
(662) 449-7970
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
AR20697
AR
Other
Enumeration date
04/05/2017
Last updated
04/05/2017
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