Magic Mart Pharmacy,inc
Pharmacy in Indianola, MS. Organization (NPI-2).
NPI number1194804591
StatusActive
Last updated in NPPESDec 19, 2019
Details
- NPI
- 1194804591
- Entity type
- Organization (NPI-2)
- Legal business name
- Magic Mart Pharmacy,inc
- Organization subpart
- No
- Enumeration date
- Nov 4, 2006
- Certification date
- Dec 19, 2019
- Last updated
- Dec 19, 2019
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 333600000X | Pharmacy | 01301 | MS | Yes |
Practice location
903 Highway 82 E Bldg GIndianola, MS 38751-2325
Phone 662-887-4135 · Fax 662-887-9703
Mailing address
903 Highway 82 E Bldg GIndianola, MS 38751-2325
Phone 662-887-4135 · Fax 662-887-9703
Authorized official
Guy M Malone
President
6628874135
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