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VICKSBURG SPECIAL CARE PHARMACY AND COMPOUNDING LLC

Medical Equipment Supplier Yellow Pages

Vicksburg, Mississippi

Provider NPI: 1659606663

Organization Information:
Organization Name:  VICKSBURG SPECIAL CARE PHARMACY AND COMPOUNDING LLC


Practice Location:
4079 PEMBERTON SQUARE BLVD  VICKSBURG, MS 39180 US
Tel: 601-636-5555  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
N333600000XSuppliers
Pharmacy
Y3336C0003XSuppliers
Pharmacy
MS08249/1.1

Other Provider Identifiers:

IssuerNumberStateType
123555LA05
PK212210801
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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