Provider Demographics
NPI:1275386120
Name:CITY REXALL DRUGS INC
Entity Type:Organization
Organization Name:CITY REXALL DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GRIFFIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-798-4761
Mailing Address - Street 1:349 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PICAYUNE
Mailing Address - State:MS
Mailing Address - Zip Code:39466-4415
Mailing Address - Country:US
Mailing Address - Phone:601-798-4761
Mailing Address - Fax:601-798-4714
Practice Address - Street 1:349 S MAIN ST
Practice Address - Street 2:
Practice Address - City:PICAYUNE
Practice Address - State:MS
Practice Address - Zip Code:39466-4415
Practice Address - Country:US
Practice Address - Phone:601-798-4761
Practice Address - Fax:601-798-4714
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:CITY REXALL DRUGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336L0003XSuppliersPharmacyLong Term Care Pharmacy