NPI 1801488846

Allen Elliott Lane, RPH

Practitioner Ambulatory Care Pharmacist Moss Point, MS

Practice location

Address: 4931 Main St, Moss Point, MS 39563-2746
Phone: (228) 474-4663
Fax: (228) 474-5545
Mailing address: PO Box 8647, Moss Point, MS 39562-0010

Registered specialties

Ambulatory Care Pharmacist Primary

Pharmacy Service Providers Taxonomy 1835P2201X Licence E-07228 (MS)

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Registry record

NPI: 1801488846
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Feb 2021
Record last updated: 10 Feb 2021

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.