Provider Demographics
NPI:1568276046
Name:CITY DRUG 2, LLC
Entity type:Organization
Organization Name:CITY DRUG 2, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:MR
Authorized Official - First Name:REAGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:BROWN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-892-4121
Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:HAZLEHURST
Mailing Address - State:MS
Mailing Address - Zip Code:39083-0766
Mailing Address - Country:US
Mailing Address - Phone:601-892-4124
Mailing Address - Fax:601-892-1919
Practice Address - Street 1:27190 HIGHWAY 28 STE 100
Practice Address - Street 2:
Practice Address - City:HAZLEHURST
Practice Address - State:MS
Practice Address - Zip Code:39083-2224
Practice Address - Country:US
Practice Address - Phone:601-892-4124
Practice Address - Fax:601-892-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy