Organization
CEDAR LAKE PHARMACY
Active
Other names
Cedar Lake Pharmacy LLC.
Organization subpart
No
Provider details
NPI number
Authorized official
THUY T NGUYEN (PIC/OWNER)
(228) 396-4412
Entity
Organization
Contact information
Practice address
921 CEDAR LAKE RD STE F, BILOXI, MS 39532-2126
(228) 396-4412
(228) 396-4414
Mailing address
921 CEDAR LAKE RD STE F, BILOXI, MS 39532-2126
(228) 396-4412
(228) 396-4414
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
—
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008773390
—
MS
01
—
1689984031
NPI
MS
Enumeration date
10/19/2010
Last updated
06/13/2025
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