South Street Pharmacy
NPI #1306906482 in Cleveland, Mississippi
Provider Information
- NPI Number
- 1306906482
- Entity Type
- Organization
- Organization Name
- South Street Pharmacy
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Dec 11, 2006
- Last Updated
- Mar 20, 2018
Practice Location
- Address
- 410 SOUTH ST
- City
- Cleveland
- State
- Mississippi
- ZIP Code
- 38732-3450
- Phone
- (662) 843-6700
Authorized Official
- Name
- MICHAEL STUART CLARK II
- Title
- PHARMACIST OWNER
- Phone
- (662) 843-6700
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
| Pharmacy - Long Term Care Pharmacy — Long Term Care Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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