Organization
BATTLEFIELD CLINIC DRUGS
Active
Other names
Battlefield Clinic Drugs
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN STOREY (OWNER)
(601) 636-3374
Entity
Organization
Contact information
Practice address
2080 S FRONTAGE RD, STE N, VICKSBURG, MS 39180-5328
(601) 636-2236
(601) 636-2264
Mailing address
2080 S FRONTAGE RD, STE N, VICKSBURG, MS 39180-5328
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
07824/01.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2587369
NCPDP PROVIDER IDENTIFICATION NUMBER
—
Enumeration date
09/29/2008
Last updated
10/10/2008
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