Southern Express Pharmacy

NPI #1073078481 in Bolivar, Tennessee

Provider Information

NPI Number: 1073078481
Entity Type: Organization
Organization Name: Southern Express Pharmacy
Primary Specialty: Pharmacy
Enumeration Date: Feb 10, 2019
Last Updated: Aug 2, 2019

Practice Location

Address: 1355 W MARKET ST
City: Bolivar
State: Tennessee
ZIP Code: 38008-1715
Phone: (731) 472-1011

Authorized Official

Name: DR. ELIZABETH ASHLEY WILLIS, PHARMD
Title: OWNER/PHARMACIST-IN-CHARGE
Phone: (731) 472-1011

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacy	333600000X	Primary

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