Organization
NORTHLAUREL DISCOUNT DRUGS, INC.
Active
Other names
Quinn Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES L. HICKS, III RPH (PHARMACY MANAGER)
(601) 426-2370
Entity
Organization
Contact information
Practice address
104 S 13TH AVE, LAUREL, MS 39440-4112
(601) 426-2370
(601) 518-0194
Mailing address
PO BOX 87, LAUREL, MS 39441-0087
(601) 426-2370
(601) 518-0194
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
01101/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030428
—
MS
Enumeration date
07/02/2006
Last updated
06/19/2024
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