| NPI | 1366853004 |
|---|---|
| Other Name | SOUTH JACKSON WIC DISTRIBUTION |
| Entity Type | Organization |
| Authorized Contact | MITCHELL ADCOCK Chief Administrative Officer 601-576-7635 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2014-05-15 |