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Contact Information

LIBERTY DRUG STORE, INC.
110 E MAIN ST
LIBERTY, MS39645
 Phone: 601-657-8051
 Fax: 601-657-8049
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacist

183500000X
Indicates primary specialty

NPI Profile & details for LIBERTY DRUG STORE INC · (Female)

NPI Number 1639124183
Status Active
Credentials
Entity Individual
Enumeration date 05/23/2006
Last updated 12/07/2023 - About 2 years ago
Sole proprietor 1 Not specified
Identifiers
  • MS License # T08879
  • MS Medicaid 00330466
  • MS Medicaid 00440833
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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