Waveland Pharmacy Llc

NPI 1679507644 - Pharmacy - 333600000X

NPI Details
NPI 1679507644
Enumeration Date 07/10/2006
Last Updated 12/14/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name RUDY RUDY
Position OWNER PHCST
Phone (228) 463-1055
Fax (228) 463-0117
Practice Location
112 AUDERER BLVD
WAVELAND MS, 39576-2432, US
Phone (228) 463-1055
Fax (228) 463-0117
Business Location
PO BOX 4617
BAY ST LOUIS MS, 39521-4617, US
Phone (228) 463-1055
Fax
Toxanomy
Taxonomy Code 333600000X
License State
License Number
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According to our database, Waveland Pharmacy Llc NPI is 1679507644, taxonomy code is 333600000X Waveland Pharmacy Llc physically located at 112 Auderer Blvd, Waveland MS, 39576-2432. NPI Number 1033115704 has the healthcare provider type.

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1679507644 NPI number is provided on an as is basis without warranty of any kind. 1679507644 is maintained by the National Plan & Provider Enumeration System. The contents of Waveland Pharmacy Llc are for informational purposes only.