Provider Demographics
NPI:1750437059
Name:DUTCH PHARMACIES INC
Entity type:Organization
Organization Name:DUTCH PHARMACIES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-327-5202
Mailing Address - Street 1:113 N LEHMBERG RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39702-5541
Mailing Address - Country:US
Mailing Address - Phone:662-329-1810
Mailing Address - Fax:662-329-1437
Practice Address - Street 1:113 N LEHMBERG RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-5541
Practice Address - Country:US
Practice Address - Phone:662-329-1810
Practice Address - Fax:662-329-1437
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:DUTCH PHARMACIES INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-01-27
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL100230086Medicaid
MS00330479Medicaid