Lee Brian Lott, RPH

Individual provider Active NPI Pharmacist · Water Valley, MS

NPI 1043737729 · NPPES record last updated Aug 24, 2017

Key facts

NPI
1043737729
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
T8585 (MS)
Practice address
409 Duncan St
Water Valley, MS 38965-2547
Phone
(662) 473-3333
Fax
(662) 473-3788
NPI assigned
Aug 24, 2017
Sex
Male
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
T8585MSMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Freds Stores of Tennessee Inc Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X T8585 MS Yes

Addresses

Primary practice location

409 Duncan St
Water Valley, MS 38965-2547

Mailing address

1345 Highway 7 S
Water Valley, MS 38965-3755
Phone (662) 473-6631

Other providers in Water Valley, MS

All providers in Water Valley, MS · Pharmacist in Mississippi

Sources for this page

Verify at the official NPI Registry.