Provider Demographics
NPI:1043244361
Name:TRIPLETT DAY DRUG CO INC
Entity type:Organization
Organization Name:TRIPLETT DAY DRUG CO INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:BS
Authorized Official - Phone:228-863-2363
Mailing Address - Street 1:2429 14TH ST
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2020
Mailing Address - Country:US
Mailing Address - Phone:228-863-2363
Mailing Address - Fax:228-863-1515
Practice Address - Street 1:2429 14TH ST
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2020
Practice Address - Country:US
Practice Address - Phone:228-863-2363
Practice Address - Fax:228-863-1515
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-11
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MS005243336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00034690Medicaid
2050545OtherPK