Provider Demographics
NPI:1386688620
Name:OCEAN SPRINGS DISCOUNT PHARMACY, INC
Entity Type:Organization
Organization Name:OCEAN SPRINGS DISCOUNT PHARMACY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:CYNTHIA
Authorized Official - Middle Name:L
Authorized Official - Last Name:BAMBURG
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:228-424-3478
Mailing Address - Street 1:2120 BIENVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564-3017
Mailing Address - Country:US
Mailing Address - Phone:228-875-8330
Mailing Address - Fax:228-875-8766
Practice Address - Street 1:2120 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564-3017
Practice Address - Country:US
Practice Address - Phone:228-875-8330
Practice Address - Fax:228-875-8766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS06811/01.1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty