Provider Demographics
NPI:1215302617
Name:DUNCAN'S PHARMACY, INC.
Entity type:Organization
Organization Name:DUNCAN'S PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST DIABETES EDUCATOR
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILBURN
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD, CDE, CPT
Authorized Official - Phone:662-223-4727
Mailing Address - Street 1:28271 HIGHWAY 15
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:MS
Mailing Address - Zip Code:38683-8930
Mailing Address - Country:US
Mailing Address - Phone:662-223-4727
Mailing Address - Fax:662-223-5899
Practice Address - Street 1:28271 HIGHWAY 15
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:MS
Practice Address - Zip Code:38683-8930
Practice Address - Country:US
Practice Address - Phone:662-223-4727
Practice Address - Fax:662-223-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-10
Last Update Date:2015-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS01789/1.13336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy