Medi Center Pharmacy

LBN: Medi Center Pharmacy
Medi Center Pharmacy is an health care organization with primary practice located at 1629 N State St , Clarksdale MS 38614-6617. 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. Medi Center Pharmacy can be contacted via phone (662) 624-6561, or through Chow, Audric via phone (662) 624-6561.

Contact Information

Primary practice address
1629 N State St Clarksdale MS 38614-6617
Phone: (662) 624-6561
Fax: (662) 627-2845
Website:
Map and Directions
Authorized official contact:
Name: Chow, Audric PHRM
Phone: (662) 624-6561

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 01632011 Mississippi
Suppliers / Community/Retail Pharmacy 3336C0003X

Profile Details

NPI number 1093883233
LBN Legal business name Medi Center Pharmacy
DBA Doing business as
Authorized official Chow, Audric PHRM
Entity Organization
Organization subpart 1 No
Enumeration date Dec 4th, 2006
Last updated Aug 13th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093883233 NPPES
Mississippi MEDICAID 00095109
Mississippi Other 2511043

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