Provider Demographics
NPI:1275643207
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:MR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:662-327-5052
Mailing Address - Street 1:1245 N LEHMBERG RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:MS
Mailing Address - Zip Code:39702-3224
Mailing Address - Country:US
Mailing Address - Phone:662-329-9060
Mailing Address - Fax:662-329-9061
Practice Address - Street 1:1245 N LEHMBERG RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:MS
Practice Address - Zip Code:39702-3224
Practice Address - Country:US
Practice Address - Phone:662-329-9060
Practice Address - Fax:662-329-9061
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-30
Last Update Date:2025-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes333600000XSuppliersPharmacy
No3336C0003XSuppliersPharmacyCommunity/Retail PharmacyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0030218Medicaid
AL100230078Medicaid