Provider Demographics
NPI:1518034347
Name:HAMMONDS PHARMACY INC
Entity type:Organization
Organization Name:HAMMONDS PHARMACY INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:VIRGINIA
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAMMOND
Authorized Official - Suffix:
Authorized Official - Credentials:RPH BS
Authorized Official - Phone:662-283-8802
Mailing Address - Street 1:PO BOX 309
Mailing Address - Street 2:405C N APPLEGATE
Mailing Address - City:WINONA
Mailing Address - State:MS
Mailing Address - Zip Code:38967
Mailing Address - Country:US
Mailing Address - Phone:662-283-8802
Mailing Address - Fax:662-283-8876
Practice Address - Street 1:405C N APPLEGATE
Practice Address - Street 2:
Practice Address - City:WINONA
Practice Address - State:MS
Practice Address - Zip Code:38967
Practice Address - Country:US
Practice Address - Phone:662-283-8502
Practice Address - Fax:662-283-8876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS09408872Medicaid
MS09408872Medicaid