Organization
DELTA PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KIMBERLY HEENEY (CONSULTANT)
(305) 282-8298
Entity
Organization
Contact information
Practice address
108 COMMERCE AVE, CLEVELAND, MS 38732-2736
(662) 846-6560
(662) 546-6592
Mailing address
108 COMMERCE AVE, CLEVELAND, MS 38732-2736
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
06929011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2586672
OTHER ID NUMBER
—
Enumeration date
08/31/2006
Last updated
12/19/2007
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