Dr. Carroll Bruister III
Pharmacist in Ackerman, MS. Individual provider (NPI-1).
NPI number1982122289
StatusActive
Last updated in NPPESSep 7, 2017
Details
- NPI
- 1982122289
- Entity type
- Individual (NPI-1)
- Name
- Dr. Carroll Bruister III
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 7, 2017
- Last updated
- Sep 7, 2017
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 183500000X | Pharmacist | e6788 | MS | Yes |
Practice location
222 MabusAckerman, MS 39735
Phone 662-285-6039
Mailing address
11850 Ms Hwy 15Ackerman, MS 39735
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