Chris Cheatham

Individual provider Active NPI Pharmacist · Philadelphia, MS

NPI 1497063770 · NPPES record last updated Sep 20, 2010

Key facts

NPI
1497063770
Entity type
Individual (NPI type 1)
Primary specialty
Pharmacist 183500000X
License
8045 (MS)
Practice address
714 Pecan Ave
Philadelphia, MS 39350-3402
Phone
(601) 656-2545
NPI assigned
Sep 20, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

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

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
8045MSMDPharmacist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 8045 MS Yes

Addresses

Primary practice location

714 Pecan Ave
Philadelphia, MS 39350-3402

Mailing address

714 Pecan Ave
Philadelphia, MS 39350-3402

Other providers in Philadelphia, MS

All providers in Philadelphia, MS · Pharmacist in Mississippi

Sources for this page

Verify at the official NPI Registry.