Provider Demographics
NPI:1497497960
Name:DHP BROOKHAVEN, INC
Entity Type:Organization
Organization Name:DHP BROOKHAVEN, INC
Other - Org Name:DOWNHOME PHARMACY BROOKHAVEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT/OWNER/RPH
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:EARL
Authorized Official - Last Name:CRANE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-967-8411
Mailing Address - Street 1:1037 HIGHWAY 84 E
Mailing Address - Street 2:
Mailing Address - City:BROOKHAVEN
Mailing Address - State:MS
Mailing Address - Zip Code:39601-8776
Mailing Address - Country:US
Mailing Address - Phone:601-695-0210
Mailing Address - Fax:601-756-2001
Practice Address - Street 1:1037 HIGHWAY 84 E
Practice Address - Street 2:
Practice Address - City:BROOKHAVEN
Practice Address - State:MS
Practice Address - Zip Code:39601-8776
Practice Address - Country:US
Practice Address - Phone:601-967-8411
Practice Address - Fax:833-481-3378
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-13
Last Update Date:2022-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy