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1508528159
MANSOUR SHABAZZ
JACKSON, MS
NPI
1508528159
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
183500000X Pharmacist
(Licence: MS T-15998)
Enumeration Date
2021-10-12
Last Update Date
2021-10-12
Business Address
MANSOUR SHABAZZ PharmD
977 ELLIS AVE
JACKSON, MS 39209-6256
Phone number: 601-944-9965
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Mailing Address
MANSOUR SHABAZZ PharmD
977 ELLIS AVE
JACKSON, MS 39209-6256
Phone number: 601-944-9965
Copy
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