Sullivan'S Drug Store,Inc

LBN: Sullivan'S Drug Store,Inc
Sullivan'S Drug Store,Inc is an health care organization with primary practice located at 107 Van Voris St , Batesville MS 38606-2198. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Sullivan'S Drug Store,Inc can be contacted via phone (662) 563-7687, or through Sullivan, Randell Glenn via phone (662) 563-7687.

Contact Information

Primary practice address
107 Van Voris St Batesville MS 38606-2198
Phone: (662) 563-7687
Fax: (662) 563-0260
Website:
Map and Directions
Authorized official contact:
Name: Sullivan, Randell Glenn R.PH.
Phone: (662) 563-7687

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 00481/01.1 Mississippi

Profile Details

NPI number 1700965811
LBN Legal business name Sullivan'S Drug Store,Inc
DBA Doing business as
Authorized official Sullivan, Randell Glenn R.PH.
Entity Organization
Organization subpart 1 No
Enumeration date Nov 2nd, 2006
Last updated Aug 22nd, 2020 - about 5 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 1700965811 NPPES
Mississippi MEDICAID 00034444

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