Organization
MEDICAL PLAZA ON HARPER LLC
Active
Other names
MEDICAL PLAZA ON HARPER
Organization subpart
No
Provider details
NPI number
Authorized official
JESSE BART DORAN (PHARMACIST IN CHARGE)
(662) 286-6337
Entity
Organization
Contact information
Practice address
1425 S. HARPER ROAD, CORINTH, MS 38834
(662) 286-6337
(662) 396-6333
Mailing address
1425 S. HARPER ROAD, CORINTH, MS 38834
(662) 286-6337
(662) 396-6333
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
08781/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00529591
—
MS
01
—
2588412
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
08/18/2011
Last updated
09/02/2015
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