Organization
HERITAGE HOSPICE PHARMACY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RICKY EDWARD BURGESS R.PH. (PHARMACIST)
(662) 286-5383
Entity
Organization
Contact information
Practice address
301 E WALDRON ST, CORINTH, MS 38834-4756
(662) 286-5383
(662) 286-0052
Mailing address
301 E WALDRON ST, CORINTH, MS 38834-4756
(662) 286-5383
(662) 286-0052
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E7621
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
05884
PHARMACY PERMIT
MS
Enumeration date
03/01/2007
Last updated
08/22/2020
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