Vicksburg Special Care Pharmacy and Compounding LLC
NPI #1659606663 in Vicksburg, Mississippi
Provider Information
- NPI Number
- 1659606663
- Entity Type
- Organization
- Organization Name
- Vicksburg Special Care Pharmacy and Compounding LLC
- Primary Specialty
- Pharmacy - Community/Retail Pharmacy
- Enumeration Date
- Oct 8, 2009
- Last Updated
- Oct 7, 2016
Practice Location
- Address
- 4079 PEMBERTON SQUARE BLVD
- City
- Vicksburg
- State
- Mississippi
- ZIP Code
- 39180-5580
- Phone
- (601) 636-5555
Authorized Official
- Name
- JASON RUTLAND, PHARM D
- Title
- MGR
- Phone
- (601) 983-1239
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacy |
| Pharmacy - Community/Retail Pharmacy — Community/Retail Pharmacy |
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