Family Drug Mart of Poplarville,LLC
Organization Active NPI Pharmacy · Poplarville, MS
NPI 1306325402 · NPPES record last updated Dec 24, 2021
Key facts
- NPI
- 1306325402
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 17206 (MS)
- Legal business name
- FAMILY DRUG MART OF POPLARVILLE,LLC
- Practice address
- 100 Highway 11 N
Poplarville, MS 39470-2217 - Phone
- (504) 338-7992
- Fax
- (985) 727-7494
- NPI assigned
- Aug 9, 2018
- Organization subpart
- No
Authorized official
- Name
- Mr. Jose Miguel Yanez, RPH
- Title
- Owner/Pharmacist
- Phone
- (504) 338-7992
National Provider Directory
Locations
100 Highway 11 N
Poplarville, MS 39470
Phone (504) 338-7992
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 17206 | MS | Yes |
Addresses
Primary practice location
100 Highway 11 N
Poplarville, MS 39470-2217
Mailing address
2299 Sunset Blvd
Slidell, LA 70461-5605
Phone (504) 338-7992
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9030801 | Medicaid | MS |
Other names
- FAMILY DRUG MART OF POPLARVILLE
Other providers in Poplarville, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 24, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.