Organization
COMPLETE DIABETES PHARMACY CARE INC
Active
Other names
Complete Diabetes Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG BROSSEAU (SECRETARY)
(952) 646-3255
Entity
Organization
Contact information
Practice address
7165 SWINNEA RD, BLDG B-2, SOUTHAVEN, MS 38671-6360
(662) 280-5533
(800) 208-0863
Mailing address
7165 SWINNEA RD, BUILDING B-2, SOUTHAVEN, MS 38671-6360
(662) 280-5533
(800) 208-0863
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
13340
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2145616
PK
—
Enumeration date
04/15/2014
Last updated
11/11/2022
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