Organization
P & S PHARMACY, INC
Active
Other names
P AND S PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
CLAYTON NAGLE (OWNER/PRESIDENT)
(662) 746-1341
Entity
Organization
Contact information
Practice address
804 GRAND AVE, YAZOO CITY, MS 39194-3234
(662) 746-1341
(662) 716-7123
Mailing address
PO BOX 132, YAZOO CITY, MS 39194-0132
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
00741011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0030049
—
MS
01
—
2507993
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/10/2006
Last updated
06/13/2011
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