Organization
MITCHELLS PHARMACY INC
Active
Other names
MITCHELLS PHARMACY INC
Organization subpart
No
Provider details
NPI number
Authorized official
DWAYNE MITCHELL RPH (OWNER & PHARMACIST)
(318) 259-7466
Entity
Organization
Contact information
Practice address
202 E MAIN ST, JONESBORO, LA 71251
(318) 259-7466
(318) 259-8019
Mailing address
202 E MAIN ST, JONESBORO, LA 71251-3202
(318) 259-7466
(318) 259-8019
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
2804
LA
333600000X
Pharmacy
2804
LA
3336C0003X
Community/Retail Pharmacy
Primary
PHY.002804-IR
LA
3336C0004X
Compounding Pharmacy
—
—
3336L0003X
Long Term Care Pharmacy
2804
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1261319
—
LA
01
—
2032909
PK
—
Enumeration date
01/08/2007
Last updated
06/20/2018
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