Provider Demographics
NPI:1215654652
Name:DELEE SPECIALTY SERVICES LLC
Entity type:Organization
Organization Name:DELEE SPECIALTY SERVICES LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:DAWSON
Authorized Official - Middle Name:
Authorized Official - Last Name:DELEE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:769-247-1240
Mailing Address - Street 1:PO BOX 1097
Mailing Address - Street 2:
Mailing Address - City:WOODVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39669-1097
Mailing Address - Country:US
Mailing Address - Phone:769-247-1240
Mailing Address - Fax:769-247-1241
Practice Address - Street 1:251 US HIGHWAY 61 N
Practice Address - Street 2:
Practice Address - City:WOODVILLE
Practice Address - State:MS
Practice Address - Zip Code:39669-4619
Practice Address - Country:US
Practice Address - Phone:769-247-1240
Practice Address - Fax:769-247-1241
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-26
Last Update Date:2023-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy