Organization
SHELBY DRUG CO INC HWY 61 SOUTH
Active
Other names
QUITMAN DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
DONALD H HAYNES RPH (OWNER/PHARM)
(662) 326-3505
Entity
Organization
Contact information
Practice address
1026 MARTIN LUTHER KING DR, MARKS, MS 38646-1832
(662) 326-3505
(662) 326-6916
Mailing address
1026 MARTIN LUTHER KING DR, MARKS, MS 38646-1832
(662) 326-3505
(662) 326-6916
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
01675/1.1
MS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00090345
—
MS
01
—
2044766
PK
—
Enumeration date
11/20/2006
Last updated
01/15/2019
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