Organization
MISSISSIPPI CVS PHARMACY LLC
Active
Other names
CVS PHARMACY # 08993
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN F COLBERT (DIRECTOR)
(401) 765-1500
Entity
Organization
Contact information
Practice address
365 COLE RD, HATTIESBURG, MS 39402
(601) 261-2244
Mailing address
1 CVS DR, BOX 1075, WOONSOCKET, RI 02895-6146
(401) 765-1500
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
—
—
333600000X
Pharmacy
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2589337
NCPDP
MS
05
—
DME 05377397
—
MS
Enumeration date
09/26/2013
Last updated
07/07/2014
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