Individual
SAMANTHA ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1628 SIMPSON HIGHWAY 49, MAGEE, MS 39111-4294
(601) 849-4959
Mailing address
1628 SIMPSON HIGHWAY 49, MAGEE, MS 39111-4294
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E-12058
MS
Other
Enumeration date
12/19/2011
Last updated
12/19/2011
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