Provider Demographics
NPI:1083795561
Name:TERRY DISCOUNT DRUGS
Entity Type:Organization
Organization Name:TERRY DISCOUNT DRUGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:LAMBERT
Authorized Official - Middle Name:
Authorized Official - Last Name:LANE
Authorized Official - Suffix:I
Authorized Official - Credentials:
Authorized Official - Phone:601-878-5841
Mailing Address - Street 1:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:TERRY
Mailing Address - State:MS
Mailing Address - Zip Code:39170-0037
Mailing Address - Country:US
Mailing Address - Phone:601-878-5841
Mailing Address - Fax:
Practice Address - Street 1:128 CUNNINGHAM ST
Practice Address - Street 2:
Practice Address - City:TERRY
Practice Address - State:MS
Practice Address - Zip Code:39170
Practice Address - Country:US
Practice Address - Phone:601-878-5841
Practice Address - Fax:601-878-9238
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS01140011332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0628380001Medicare ID - Type Unspecified