Provider Demographics
NPI:1568548022
Name:DURST DISCOUNT DRUGS, INC.
Entity Type:Organization
Organization Name:DURST DISCOUNT DRUGS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:LOW
Authorized Official - Last Name:DURST
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-636-4333
Mailing Address - Street 1:3117 HALLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-5109
Mailing Address - Country:US
Mailing Address - Phone:601-636-4333
Mailing Address - Fax:601-636-5459
Practice Address - Street 1:3117 HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-5109
Practice Address - Country:US
Practice Address - Phone:601-636-4333
Practice Address - Fax:601-636-5459
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS02377/01.1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00330034Medicaid
MS00330034Medicaid