Organization
MICHAEL L ATKEISON
Active
Other names
ECRU DISCOUNT PHARMACY
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL ATKEISON RPH (OWNER AND RPH)
(662) 489-8084
Entity
Organization
Contact information
Practice address
186 MAIN ST, ECRU, MS 38841-9432
(662) 489-8080
(662) 489-8484
Mailing address
PO BOX 397, ECRU, MS 38841-0397
(662) 489-8084
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
F02094
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030506
—
MS
01
—
2045119
PK
—
Enumeration date
04/25/2007
Last updated
08/08/2013
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