Organization
BOSWELL REGIONAL CENTER
Active
Other names
BOSWELL REGIONAL CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD VANCE RPH (PHARMACIST)
(601) 867-5000
Entity
Organization
Contact information
Practice address
1049 HWY 149, MAGEE, MS 39111
(601) 867-5000
(601) 867-5236
Mailing address
PO BOX 128, MAGEE, MS 39111-0128
Taxonomy
Speciality
Code
Description
License number
State
3336I0012X
Institutional Pharmacy
Primary
01473046
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030185
—
MS
01
—
2045521
PK
—
Enumeration date
07/24/2006
Last updated
07/17/2013
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