Provider Demographics
NPI:1386611077
Name:GRIFFIN DRUGS INC.
Entity type:Organization
Organization Name:GRIFFIN DRUGS INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:L
Authorized Official - Last Name:BIGNER
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-684-3401
Mailing Address - Street 1:208 W PRESLEY BLVD
Mailing Address - Street 2:
Mailing Address - City:MCCOMB
Mailing Address - State:MS
Mailing Address - Zip Code:39648-5524
Mailing Address - Country:US
Mailing Address - Phone:601-684-3401
Mailing Address - Fax:
Practice Address - Street 1:208 W PRESLEY BLVD
Practice Address - Street 2:
Practice Address - City:MCCOMB
Practice Address - State:MS
Practice Address - Zip Code:39648-5524
Practice Address - Country:US
Practice Address - Phone:601-684-3401
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-02
Last Update Date:2019-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS01609/01.1333600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00030338Medicaid
LA1268542Medicaid
MS00030338Medicaid