Provider Demographics
NPI:1922026962
Name:GRAHAM SERVICES, INC.
Entity type:Organization
Organization Name:GRAHAM SERVICES, INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHARMACIST
Authorized Official - Prefix:MR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:G
Authorized Official - Last Name:GRAHAM
Authorized Official - Suffix:II
Authorized Official - Credentials:RPH
Authorized Official - Phone:662-365-5294
Mailing Address - Street 1:111 SOUTH SECOND AVE.
Mailing Address - Street 2:P.O. DRAWER B
Mailing Address - City:BALDWYN
Mailing Address - State:MS
Mailing Address - Zip Code:38824-0047
Mailing Address - Country:US
Mailing Address - Phone:662-365-5294
Mailing Address - Fax:662-365-5295
Practice Address - Street 1:111 S 2ND ST
Practice Address - Street 2:
Practice Address - City:BALDWYN
Practice Address - State:MS
Practice Address - Zip Code:38824-2216
Practice Address - Country:US
Practice Address - Phone:662-365-5294
Practice Address - Fax:662-365-5295
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-5900183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00330515Medicaid
MS00440670Medicaid
MS0525020001Medicare ID - Type Unspecified