Sanders, Jack Larry
Sanders, Jack Larry is an sole proprietor health care provider with primary practice located at 3160 Audubon Dr , Laurel MS 39440. He recently has only one registered license in Pharmacy Service Providers / Pharmacist, which is considered as his primary health care specialty. Sanders, Jack Larry can be contacted via phone (601) 428-0688.Contact Information
Primary practice address
3160 Audubon Dr
Laurel MS 39440
Phone: (601) 428-0688
Fax: (601) 428-0689
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Pharmacist | 183500000X | E-06744 | Mississippi |
Profile Details
| NPI number | 1619050150 |
|---|---|
| LBN Legal business name | Sanders, Jack Larry |
| Credentials | R PH |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619050150 | NPPES |
| Mississippi | Other | E-06744 | STATE LICENSE NUMBER |
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