Organization
CONTROLEX ENTERPRISES, INC.
Active
Other names
LOVELACE DRUG STORE
Organization subpart
No
Provider details
NPI number
Authorized official
MS. MODENA S CANNON (PHARMACY OPERATIONS MANAGER)
(228) 769-7067
Entity
Organization
Contact information
Practice address
801 WASHINGTON AVE, OCEAN SPRINGS, MS 39564-4637
(228) 875-4272
(228) 875-2651
Mailing address
1420 INGALLS AVE, PASCAGOULA, MS 39567-5650
(228) 875-4272
(228) 875-2651
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
07128/01.2
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00036331
—
MS
01
—
2586709
NCPDP
MS
Enumeration date
11/01/2006
Last updated
06/04/2008
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