Organization
MACON CITY DRUG STORE, INC.
Active
Parent organization
MACON CITY DRUG STORE, INC.
Other names
Brooksville Drug Store
Organization subpart
Yes
Provider details
NPI number
Legal business name
MACON CITY DRUG STORE, INC.
Authorized official
MR. WILLIAM J BELL JR. (OWNER)
(662) 738-5041
Entity
Organization
Contact information
Practice address
1556 N OLIVER ST, BROOKSVILLE, MS 39739-4003
(662) 738-5041
(662) 738-5043
Mailing address
PO BOX 312, BROOKSVILLE, MS 39739-0312
(662) 738-5041
(662) 738-5043
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
06158
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06689871
—
MS
Enumeration date
02/13/2007
Last updated
05/12/2020
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