Organization
SOUTHERN SPECIALTY CLINIC, LLC
Active
Parent organization
SOUTHERN SPECIALTY CLINIC, LLC
Other names
Southern Specialty Pharmacy
Organization subpart
Yes
Provider details
NPI number
Legal business name
SOUTHERN SPECIALTY CLINIC, LLC
Authorized official
DR. SHARON MARIE PENNINGTON MD (CHIEF EXECUTIVE OFFICER)
(601) 985-8296
Entity
Organization
Contact information
Practice address
803 LIBERTY RD, FLOWOOD, MS 39232-9000
(601) 714-1967
(601) 714-1966
Mailing address
122 WOODLANDS GLEN CIR, BRANDON, MS 39047-7107
(601) 985-8296
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
—
—
Other
Enumeration date
11/12/2024
Last updated
11/12/2024
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