Ellisville Drug Acquisition Co.
NPI #1396829438 in Ellisville, Mississippi
Provider Information
- NPI Number
- 1396829438
- Entity Type
- Organization
- Organization Name
- Ellisville Drug Acquisition Co.
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Oct 25, 2006
- Last Updated
- Apr 27, 2010
Practice Location
- Address
- 915 HILL ST
- City
- Ellisville
- State
- Mississippi
- ZIP Code
- 39437-2419
- Phone
- (601) 477-3573
Authorized Official
- Name
- MR. DEBORAH R KEAVENY
- Title
- CONTRACTING MANAGER
- Phone
- (612) 227-7811
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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