Organization
GILLIS EXPRESS INC
Active
Other names
Gillis Express Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
TOM ASSAF (PHARMACIST/PRESIDENT)
(601) 684-2621
Entity
Organization
Contact information
Practice address
1015 DELAWARE AVE STE A, MCCOMB, MS 39648-3827
(601) 250-5516
(601) 250-5519
Mailing address
1015 DELAWARE AVE STE A, MCCOMB, MS 39648-3827
(601) 250-5516
(601) 250-5519
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
08452011
MS
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2588018
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
04/20/2010
Last updated
12/29/2010
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