Organization · Type 2 NPI

Diamondhead Health Mart Pharmacy,llc

Community/Retail Pharmacy · Diamondhead, MS

NPI number 1003207895 Active

Practice location

4405 E Aloha Dr # Aa
Diamondhead, MS 39525-3380

Call (228) 222-4662 Map

Fax (228) 222-4733

Mailing address

PO Box 4258
Bay St. Louis, MS 39521-4258

Specialties and licenses

Taxonomy	Code	License
Community/Retail Pharmacy Primary	3336C0003X	14221/1.1 (MS)

Community/Retail Pharmacy: A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other …

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NPI record

NPI: 1003207895
Entity type: Organization (Type 2)
Issued: Feb 15, 2015
Last updated: Nov 30, 2021
Status: Active

Other names

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Diamondhead Health Mart Pharmacy · doing business as
Pharmacy In Diamondhead · doing business as

Authorized official

Mr. Rudy Allen Letellier, RPH
Owner/pharmacist
(228) 222-4662

Verify this record

This page mirrors the public NPPES file. For credentialing or billing, confirm it on the official CMS NPI Registry, and check the license with the state board.

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About NPI 1003207895

Diamondhead Health Mart Pharmacy,llc's National Provider Identifier is 1003207895, issued on Feb 15, 2015. The primary taxonomy on file is Community/Retail Pharmacy (3336C0003X), and the practice location is in Diamondhead, MS. The record was last updated on Nov 30, 2021.