Organization
MCM OF MISSISSIPPI LLC
Active
Other names
houston family pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER CARTER (OWNER)
(662) 542-8464
Entity
Organization
Contact information
Practice address
339 E MADISON ST, HOUSTON, MS 38851-2322
(662) 631-5055
(662) 631-5097
Mailing address
339 E MADISON ST, HOUSTON, MS 38851-2322
(662) 542-8464
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
14900/1.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08372765
—
MS
01
—
2163837
PK
—
Enumeration date
08/24/2016
Last updated
01/09/2020
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