| NPI | 1811009814 |
|---|---|
| Doing Business As | MEDISTART PHARMACY |
| Entity Type | Organization |
| Authorized Contact | KHALID MOKHTAR President 601-899-5621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: MS 0695011) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| 3336C0003X Pharmacy Community/Retail Pharmacy | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-09-12 |