NPI 1114373586

Gentex Pharma

Organisation Non-Pharmacy Dispensing Site Ridgeland, MS

Practice location

Address: 121 Marketridge Dr Suite C, Ridgeland, MS 39157-6027
Phone: (601) 990-9497
Fax: (601) 510-9318

Authorised official

Name: Ford Jennings Mundy
Title: Owner
Phone: (870) 243-1687

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X Licence 06677/6.1 (MS)

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Registry record

NPI: 1114373586
Entity type: Organization
NPI issued: 4 May 2016
Record last updated: 4 May 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.