REGION IV MH MR COMMISSION PHCY
2301b E Chambers Dr
Booneville, MS 38829
662-728-3174
Taxonomy:
Primary | Code | Category/Description | State | License Number |
---|---|---|---|---|
N | 3336C0002X | Suppliers - Pharmacy - Clinic Pharmacy | ||
Y | 3336C0003X | Suppliers - Pharmacy | MS | 06596/1.1 |
Other Provider Identifiers:
Issuer | Number | State | Type |
---|---|---|---|
PK | 2047211 | OTHER |