Provider Demographics
NPI:1700523503
Name:SLC HOLDINGS
Entity Type:Organization
Organization Name:SLC HOLDINGS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JENE
Authorized Official - Middle Name:BERRY
Authorized Official - Last Name:LANDRUM
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMACIST
Authorized Official - Phone:662-327-5400
Mailing Address - Street 1:2219 5TH ST N
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39705-2211
Mailing Address - Country:US
Mailing Address - Phone:662-327-5400
Mailing Address - Fax:662-327-5225
Practice Address - Street 1:2219 5TH ST N
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39705-2211
Practice Address - Country:US
Practice Address - Phone:662-327-5400
Practice Address - Fax:662-327-5225
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SLC HOLDINGS
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2022-05-13
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy