Provider Demographics
NPI:1083357297
Name:LOVE'S PHARMACY NO 2, INC
Entity Type:Organization
Organization Name:LOVE'S PHARMACY NO 2, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:RUSSELL
Authorized Official - Last Name:LOVE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:228-323-1304
Mailing Address - Street 1:45000 E ALOHA DR STE B
Mailing Address - Street 2:
Mailing Address - City:DIAMONDHEAD
Mailing Address - State:MS
Mailing Address - Zip Code:39525-3373
Mailing Address - Country:US
Mailing Address - Phone:228-363-6100
Mailing Address - Fax:288-363-6200
Practice Address - Street 1:45000 E ALOHA DR STE B
Practice Address - Street 2:
Practice Address - City:DIAMONDHEAD
Practice Address - State:MS
Practice Address - Zip Code:39525-3373
Practice Address - Country:US
Practice Address - Phone:228-323-1304
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-15
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy