Organization
SHELBY DRUG CO INC HWY 61 SOUTH
Active
Other names
HAIRE DRUG CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
EDDIE ELLIS RPH (OWNER)
(662) 624-2526
Entity
Organization
Contact information
Practice address
549 MEDICAL DR, CLARKSDALE, MS 38614-6733
(662) 624-2526
(662) 624-2527
Mailing address
549 MEDICAL DR, CLARKSDALE, MS 38614-6733
(662) 624-2526
(662) 624-2527
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
01807011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2513934
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
06/11/2006
Last updated
01/25/2011
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