Organization
SANDERS PHARMACY NO.5
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WYNN SANDERS (OWNER)
66223784138
Entity
Organization
Contact information
Practice address
1907 NORTH MEDICAL PARK DRIVE, GREENVILLE, MS 38701
(662) 378-4138
Mailing address
1907 NORTH MEDICAL PARK DRIVE, GREENVILLE, MS 38701
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
485801SG
MS
Other
Enumeration date
10/20/2006
Last updated
08/22/2020
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