Organization
PICAYUNE DRUG CO., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ANDREW L. FAILLA R.PH. (PRESIDENT)
(601) 798-4846
Entity
Organization
Contact information
Practice address
110 HIGHWAY 11 N, PICAYUNE, MS 39466-3312
(601) 798-4846
(601) 798-4825
Mailing address
110 HIGHWAY 11 N, P.O. BOX 10, PICAYUNE, MS 39466-3312
(601) 798-4846
(601) 798-4825
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
00937/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00030106
—
MS
05
—
00045164
—
MS
05
—
0033553
—
MS
05
—
09589297
—
MS
01
—
2506600
NABP
MS
Enumeration date
07/19/2006
Last updated
12/30/2024
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