Potts Camp Pharmacy

LBN: Tyson Drug Inc
Potts Camp Pharmacy is an health care organization with primary practice located at 41 S Center St , Potts Camp MS 38659-9531. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Tyson Drug Inc can be contacted via phone (662) 333-7782, or through Lomenick, Robert via phone (662) 252-2321.

Contact Information

Primary practice address
41 S Center St Potts Camp MS 38659-9531
Phone: (662) 333-7782
Fax: (662) 333-4095
Website:
Map and Directions
Authorized official contact:
Name: Lomenick, Robert
Phone: (662) 252-2321

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 02436/01.1 Mississippi

Profile Details

NPI number 1285639906
LBN Legal business name Tyson Drug Inc
DBA Doing business as Potts Camp Pharmacy
Authorized official Lomenick, Robert
Entity Organization
Organization subpart 1 No
Enumeration date Jun 17th, 2005
Last updated Feb 20th, 2017 - about 9 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1285639906 NPPES
Mississippi MEDICAID 00330080
Mississippi Other 2045412

Popular Providers