Organization
GULFPORT DISCOUNT DRUGS
Active
Other names
Gulfport Discount Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEVE LARRY WILSON JR. PHARMD (PHARMACIST)
(228) 424-5579
Entity
Organization
Contact information
Practice address
1105 BROAD AVE, GULFPORT, MS 39501-2415
(228) 424-5579
Mailing address
13326 MARYS WAY, DIBERVILLE, MS 39540-6610
(228) 424-5579
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
—
—
3336C0003X
Community/Retail Pharmacy
—
—
Other
Enumeration date
11/18/2021
Last updated
11/18/2021
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