Liberty Drug Store, Inc.

NPI #1639124183 in Liberty, Mississippi

Provider Information

NPI Number: 1639124183
Entity Type: Organization
Organization Name: Liberty Drug Store, Inc.
Primary Specialty: Pharmacist
Enumeration Date: May 23, 2006
Last Updated: Dec 7, 2023

Practice Location

Address: 110 E MAIN ST
City: Liberty
State: Mississippi
ZIP Code: 39645
Phone: (601) 657-8051

Authorized Official

Name: RONALD EVANS BLALOCK
Title: PRESIDENT/PHARMACIST
Phone: (601) 657-8051

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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