Provider Demographics
NPI:1205940343
Name:D AND F ENTERPRISES
Entity type:Organization
Organization Name:D AND F ENTERPRISES
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:PAUL
Authorized Official - Last Name:CHANCE
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-736-4562
Mailing Address - Street 1:508 S HIGH SCHOOL AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:MS
Mailing Address - Zip Code:39429-3000
Mailing Address - Country:US
Mailing Address - Phone:601-736-4562
Mailing Address - Fax:601-736-4563
Practice Address - Street 1:508 S HIGH SCHOOL AVE
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:MS
Practice Address - Zip Code:39429-3000
Practice Address - Country:US
Practice Address - Phone:601-736-4562
Practice Address - Fax:601-736-4563
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-18
Last Update Date:2008-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS003353336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00030250Medicaid
4982500001Medicare ID - Type UnspecifiedMEDICARE
4982500001Medicare NSC