Organization
BOONEVILLE COMMUNITY PHARMACY OF MSINC
Active
Other names
BOONEVILLE COMMUNITY PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
TONY SMITH (OWNER)
(662) 728-1951
Entity
Organization
Contact information
Practice address
206 N 2ND ST, BOONEVILLE, MS 38829-2702
(662) 728-1951
(662) 728-1873
Mailing address
206 N 2ND ST, BOONEVILLE, MS 38829-2702
(662) 728-1951
(662) 728-1873
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
04785011
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330527
—
MS
01
—
2520232
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
11/01/2006
Last updated
05/23/2023
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