Provider Demographics
NPI:1790404143
Name:EDINBURG DRUGS LLC
Entity Type:Organization
Organization Name:EDINBURG DRUGS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PIC/ OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CODIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CAUTHEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:769-257-4477
Mailing Address - Street 1:10820 HWY 427
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:MS
Mailing Address - Zip Code:39350
Mailing Address - Country:US
Mailing Address - Phone:769-257-4477
Mailing Address - Fax:
Practice Address - Street 1:3104 HWY 16
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:MS
Practice Address - Zip Code:39051-3905
Practice Address - Country:US
Practice Address - Phone:769-257-4477
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy