Organization
OAK PLACE PHARMACY
Active
Other names
OAK PLACE PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TERRY J RALEY SR. REG PHARMACIST (OWNER)
(228) 864-6647
Entity
Organization
Contact information
Practice address
1311 BROAD AVE, GULFPORT, MS 39501-2419
(228) 864-6647
(228) 864-6698
Mailing address
1311 BROAD AVE, GULFPORT, MS 39501-2419
(228) 864-6647
(228) 864-6698
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0106201.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00092053
—
MS
01
—
2508414
NABP
—
Enumeration date
03/01/2007
Last updated
08/22/2020
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