National Provider Identifier Database

LIBERTY DRUG STORE INC
Pharmacist

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.


Contact Information

LIBERTY DRUG STORE, INC.
110 E MAIN ST
LIBERTY, MS39645
Phone: 601-657-8051
Fax: 601-657-8049
Website:
Specialty Taxonomy Code
* Pharmacist 183500000X

* Indicates primary specialty

NPI Profile & details for LIBERTY DRUG STORE, INC.

NPI Number 1639124183
Legal business name
LBN
LIBERTY DRUG STORE, INC.
Authorized official RONALD BLALOCK - (PRESIDENT/PHARMACIST)
Entity Organization
Organization subpart No
Enumeration date 05/23/2006
Last updated 12/07/2023 - About 2 years ago
Sole proprietor1 Not specified
Identifiers
  • MS License #: T08879
  • MS Medicaid: 00330466
  • MS Medicaid: 00440833

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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