Provider Demographics
NPI:1346305497
Name:EAST HEIGHTS PHARMACY INC
Entity Type:Organization
Organization Name:EAST HEIGHTS PHARMACY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST AND OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:COMER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:662-844-1921
Mailing Address - Street 1:1001 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38804-2829
Mailing Address - Country:US
Mailing Address - Phone:662-844-1921
Mailing Address - Fax:662-842-7209
Practice Address - Street 1:1001 E MAIN ST
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38804-2829
Practice Address - Country:US
Practice Address - Phone:662-844-1921
Practice Address - Fax:662-842-7209
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00330307Medicaid