Controlex Enterprises, Inc.
Organization Active NPI Pharmacy · Gautier, MS
NPI 1376628792 · NPPES record last updated Aug 22, 2020
Key facts
- NPI
- 1376628792
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Pharmacy 333600000X
- License
- 00839/01.2 (MS)
- Legal business name
- CONTROLEX ENTERPRISES, INC.
- Practice address
- 2307 Highway 90
Gautier, MS 39553-5231 - Phone
- (228) 497-4090
- Fax
- (228) 762-1756
- NPI assigned
- Oct 25, 2006
- Organization subpart
- No
Authorized official
- Name
- Ms. Modena S Cannon
- Title
- Pharmacy Operations Manager
- Phone
- (228) 769-7067
Corporate family (same tax ID) 3
National Provider Directory
- Tax ID family
- Controlex Enterprises Inc
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 00839/01.2 | MS | Yes |
Addresses
Primary practice location
2307 Highway 90
Gautier, MS 39553-5231
Mailing address
1420 Ingalls Ave
Pascagoula, MS 39567-5650
Phone (228) 769-7067
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0091839 | Medicaid | MS | |
| 2503476 | Other | MS | NCPDP |
Other names
- GAUTIER SAV REX #634
Other providers in Gautier, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 22, 2020. 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.