Provider Demographics
NPI:1336283225
Name:F AND M SPECIALTY PHARMACY INC
Entity Type:Organization
Organization Name:F AND M SPECIALTY PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:FOX
Authorized Official - Last Name:SKELTON
Authorized Official - Suffix:II
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-939-9353
Mailing Address - Street 1:631 LAKELAND EAST DR
Mailing Address - Street 2:STE 700
Mailing Address - City:FLOWOOD
Mailing Address - State:MS
Mailing Address - Zip Code:39232-8815
Mailing Address - Country:US
Mailing Address - Phone:601-939-9353
Mailing Address - Fax:601-939-6353
Practice Address - Street 1:631 LAKELAND EAST DR
Practice Address - Street 2:STE 700
Practice Address - City:FLOWOOD
Practice Address - State:MS
Practice Address - Zip Code:39232-8815
Practice Address - Country:US
Practice Address - Phone:601-939-9353
Practice Address - Fax:601-939-6353
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-16
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS06187332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0440950Medicaid