Provider Demographics
NPI:1366064511
Name:HAIRE DRUG CENTER LLC
Entity type:Organization
Organization Name:HAIRE DRUG CENTER LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST IN CHARGE
Authorized Official - Prefix:
Authorized Official - First Name:ZACHERY
Authorized Official - Middle Name:
Authorized Official - Last Name:WARRINGTON
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:662-719-6895
Mailing Address - Street 1:805 1ST ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:MS
Mailing Address - Zip Code:38732-2309
Mailing Address - Country:US
Mailing Address - Phone:662-843-4211
Mailing Address - Fax:662-843-0919
Practice Address - Street 1:805 1ST ST
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:MS
Practice Address - Zip Code:38732-2309
Practice Address - Country:US
Practice Address - Phone:662-843-4211
Practice Address - Fax:662-843-0919
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NORTH SUNFLOWER MEDICAL CENTER
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2020-05-11
Last Update Date:2020-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy