Provider Demographics
NPI:1275669517
Name:RHODES & ROBBY DRUGS INC
Entity Type:Organization
Organization Name:RHODES & ROBBY DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:JACK
Authorized Official - Middle Name:HALSEY
Authorized Official - Last Name:RHODES
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-854-8252
Mailing Address - Street 1:PO BOX 249
Mailing Address - Street 2:114 BROOKS STREET
Mailing Address - City:PELAHATCHIE
Mailing Address - State:MS
Mailing Address - Zip Code:39145-0249
Mailing Address - Country:US
Mailing Address - Phone:601-854-8252
Mailing Address - Fax:601-854-6057
Practice Address - Street 1:114 BROOKS STREET
Practice Address - Street 2:
Practice Address - City:PELAHATCHIE
Practice Address - State:MS
Practice Address - Zip Code:39145-0249
Practice Address - Country:US
Practice Address - Phone:601-854-8252
Practice Address - Fax:601-854-6057
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-23
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS00253183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0033979Medicaid
MS0746910001OtherMEDICARE DME
MS2506472Medicare UPIN
MS0033979Medicaid