Organization
JIM BAIN'S COMPOUNDING PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM BAIN PRH (OWNER/PHARAMIST)
(662) 844-4530
Entity
Organization
Contact information
Practice address
367 N GLOSTER ST, TUPELO, MS 38804-3633
(662) 844-4530
(662) 844-4537
Mailing address
PO BOX 7241, TUPELO, MS 38802-7241
(662) 844-4530
(662) 844-4537
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
2101-1513-3453-350
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2586139
NCPDP
MS
Enumeration date
06/12/2006
Last updated
08/22/2020
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