Provider Demographics
NPI:1871092544
Name:BIGNER DRUGS LLC
Entity type:Organization
Organization Name:BIGNER DRUGS LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:MARTY
Authorized Official - Middle Name:
Authorized Official - Last Name:BIGNER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-384-2288
Mailing Address - Street 1:PO BOX 952
Mailing Address - Street 2:
Mailing Address - City:MEADVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:39653-0910
Mailing Address - Country:US
Mailing Address - Phone:601-384-2288
Mailing Address - Fax:
Practice Address - Street 1:488 MAIN ST EAST
Practice Address - Street 2:PO BOX 952
Practice Address - City:MEADVILLE
Practice Address - State:MS
Practice Address - Zip Code:39653
Practice Address - Country:US
Practice Address - Phone:601-384-2288
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-07
Last Update Date:2018-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00091979Medicaid