Organization · NPI-2

30a Innovations,llc

Pharmacy, Community/Retail Pharmacy · Hattiesburg, MS

NPI number1295169753
StatusActive
Last updated in NPPESSep 2, 2013

Details

NPI
1295169753
Entity type
Organization (NPI-2)
Legal business name
30a Innovations,llc
Organization subpart
No
Enumeration date
Sep 2, 2013
Last updated
Sep 2, 2013

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
3336C0003X Pharmacy, Community/Retail Pharmacy–MSYes

Other names

  • Freedom Pharmacy (Doing Business As)

Practice location

3902 Hardy St
Hattiesburg, MS 39402-1541

Phone 601-422-7813

Mailing address

Po Box 16586
Hattiesburg, MS 39404-6586

Authorized official

Michelle Scoggin
Pharmacist/Co-Owner
6014227813

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