Organization
THOMAS PHARMACY GARDINER CENTER, LLC
Active
Other names
Thomas Pharmacy Pinetree Village
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY E. THOMAS RPH (PHARMACISTT)
(601) 426-6891
Entity
Organization
Contact information
Practice address
2341 HWY 15 NORTH, LAUREL, MS 39441-4111
(601) 426-6891
(601) 428-7150
Mailing address
PO BOX 4111, LAUREL, MS 39441-4111
(601) 426-6891
(601) 428-7150
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
Primary
08532/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00330692
—
MS
01
—
5123500001
MEDICARE DME
MS
Enumeration date
06/15/2010
Last updated
06/15/2010
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