Organization
TYSON DRUGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT H LOMENICK RPH (PRESIDENT)
(662) 252-2321
Entity
Organization
Contact information
Practice address
145 E VAN DORN AVE, HOLLY SPRINGS, MS 38635-3025
(662) 252-2321
(662) 252-1656
Mailing address
145 E VAN DORN AVE, HOLLY SPRINGS, MS 38635-3025
(662) 252-2321
(662) 252-1656
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
F0500
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2590013
NCPDP
—
01
—
F0500
PHARMACY
MS
Enumeration date
12/09/2014
Last updated
01/07/2015
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