Provider Demographics
NPI:1396377198
Name:MCFERRIN, GARRY M
Entity Type:Individual
Prefix:
First Name:GARRY
Middle Name:M
Last Name:MCFERRIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7122 WILL ROBBINS HWY
Mailing Address - Street 2:
Mailing Address - City:NETTLETON
Mailing Address - State:MS
Mailing Address - Zip Code:38858-5918
Mailing Address - Country:US
Mailing Address - Phone:662-213-9468
Mailing Address - Fax:
Practice Address - Street 1:7122 WILL ROBBINS HWY
Practice Address - Street 2:
Practice Address - City:NETTLETON
Practice Address - State:MS
Practice Address - Zip Code:38858-5918
Practice Address - Country:US
Practice Address - Phone:662-529-5234
Practice Address - Fax:662-529-5229
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-10
Last Update Date:2020-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE6472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist