Provider Demographics
NPI:1346710720
Name:TUPELO SPECIALTY PHARMACY, LLC
Entity Type:Organization
Organization Name:TUPELO SPECIALTY PHARMACY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:W
Authorized Official - Last Name:FRANCIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-262-2999
Mailing Address - Street 1:1056 CLIFF GOOKIN BLVD STE C
Mailing Address - Street 2:
Mailing Address - City:TUPELO
Mailing Address - State:MS
Mailing Address - Zip Code:38801-6458
Mailing Address - Country:US
Mailing Address - Phone:662-262-2999
Mailing Address - Fax:888-232-4233
Practice Address - Street 1:1056 CLIFF GOOKIN BLVD STE C
Practice Address - Street 2:
Practice Address - City:TUPELO
Practice Address - State:MS
Practice Address - Zip Code:38801-6458
Practice Address - Country:US
Practice Address - Phone:662-262-2999
Practice Address - Fax:888-232-4233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-28
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy