Organization
SPECIALTY SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROL J WEILAND PD (OWNER PHARMACIST)
(662) 358-4500
Entity
Organization
Contact information
Practice address
1627 HIGHWAY 61 JONESTOWN RD, COAHOMA, MS 38617-9790
(662) 358-4500
(662) 358-4507
Mailing address
1627 HIGHWAY 61 JONESTOWN RD, COAHOMA, MS 38617-9790
(662) 358-4500
(662) 358-4507
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
04428/02.0
MS
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
04428/02.0
MS
333600000X
Pharmacy
OS01422
AR
3336C0004X
Compounding Pharmacy
04428 02.0
MS
3336H0001X
Home Infusion Therapy Pharmacy
Primary
04428 02.0
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330666
—
MS
05
—
0440634
—
MS
05
—
138724716
—
AR
05
—
138725733
—
AR
05
—
142601407
—
AR
Enumeration date
11/29/2006
Last updated
07/12/2010
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