Organization
RICK QUINN
Active
Other names
Prescription Shoppe
Organization subpart
No
Provider details
NPI number
Authorized official
MS. AMANDA ANN KETCHUM R.PH. (CHIEF PHARMACIST)
(662) 286-5747
Entity
Organization
Contact information
Practice address
504 ALCORN DR, CORINTH, MS 38834-9392
(662) 286-5747
(662) 286-5508
Mailing address
504 ALCORN DR, CORINTH, MS 38834-9392
(662) 286-5747
(662) 286-5508
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
03051/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0330175
—
MS
Enumeration date
08/05/2006
Last updated
11/17/2008
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