DEIDRE REYNOLDS (NPI# 1003416223) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003416223 |
| Entity Type | Individual |
| Full Name | DEIDRE REYNOLDS |
| Credential | PHARMD |
| Practice Address |
6072 U S Highway 98 Hattiesburg MS 39402-8854 |
| Practice Telephone | 6012643631 |
| Practice Fax Number | 6012640526 |
| Mailing Telephone | 6012643631 |
| Mailing Fax Number | 6012640526 |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2020-10-27 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | E-09848 | MS | Pharmacy Service Providers |
| Street Address |
6072 U S HIGHWAY 98 |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39402-8854 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063439461 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 6072 U S Highway 98, Hattiesburg, MS 39402-8854 | 2006-07-16 |
| 1487254181 | Kelly Goolsby | Pharmacist | 6072 U S Highway 98, Hattiesburg, MS 39402-8854 | 2020-10-30 |
| 1295335925 | Melissa M Odom | Pharmacist | 6072 U S Highway 98, Hattiesburg, MS 39402-8854 | 2020-10-30 |
| 1629678131 | Deidra Ilion | Pharmacist | 6072 U S Highway 98, Hattiesburg, MS 39402-8854 | 2020-10-26 |
| 1093118036 | Lisa Hillman | Pharmacist | 6072 U S Highway 98, Hattiesburg, MS 39402-8854 | 2014-10-05 |
| 1790188159 | Kristyn Mcdaniel | Pharmacist | 6072 U S Highway 98, Hattiesburg, MS 39402-8854 | 2014-09-30 |
| 1992884944 | Wal-mart Stores East, Lp | Technician/Technologist | 6072 U S Highway 98, Hattiesburg, MS 39402-8854 | 2006-11-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518572965 | Resilient Therapy and Solutions, Pllc | Clinic/Center | 5266 Old Hwy 11 Ste 50, #308, Hattiesburg, MS 39402 | 2020-09-12 |
| 1932710225 | Jones County Medical Supplies, Inc | Durable Medical Equipment & Medical Supplies | 6424 Hwy 98 West, Suite 20, Hattiesburg, MS 39402 | 2020-08-11 |
| 1467086736 | Elizabeth A. Perry | Technician | 1220 Marrie St, Hattiesburg, MS 39402 | 2020-02-26 |
| 1225678063 | Connor Gregory Galloway | Physical Therapist | 3688 Veteran Memorial Drive, Hattiesburg, MS 39402 | 2020-01-09 |
| 1487291456 | Megan Marie Smith | Social Worker | 11 Woodstone Plaza, Hattiesburg, MS 39402 | 2019-12-09 |
| 1821656612 | Julie Covington Mcmahan | Dentist | 100 Madison Plaza, Hattiesburg, MS 39402 | 2019-06-05 |
| 1295392074 | Hattiesburg Clinic, Pa | Preventive Medicine | 6414 Highway 98, Suite 120, Hattiesburg, MS 39402 | 2019-05-28 |
| 1760945356 | Rachandeep Chahal | Student in an Organized Health Care Education/Training Program | 5001 Hardy Street Merit Health Wesley, Hattiesburg, MS 39402 | 2019-04-10 |
| 1386101137 | Courtney L Smith | Behavior Technician | 32 Millbanch Road, Suite 40, Hattiesburg, MS 39402 | 2019-02-28 |
| 1891269940 | Amanda Laine Mcarthur-macisaac | Registered Nurse | 5909 Highway 49 South, Suite 30, Hattiesburg, MS 39402 | 2019-01-11 |
| Find all providers in zip 39402 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1700157989 | Virginia Lawson | Pharmacist | 5093 Hardy Street, Hattiesburg, MS 39402 | 2012-01-20 |
| 1770852360 | Larry Lee Osenbaugh | Pharmacist | 6130 Highway 49 S, Hattiesburg, MS 39401 | 2011-12-28 |
| 1518235936 | Harry Edward Mccollum | Pharmacist | 6143 U S Highway 98, Ste 80, Hattiesburg, MS 39402-4404 | 2011-12-13 |
| 1407124514 | Karol Scott St. Louis | Pharmacist | 6130 Highway 49, Hattiesburg, MS 39401-7300 | 2011-12-03 |
| 1023316163 | Alex Ambeau | Pharmacist | 4400 Hardy St, Hattiesburg, MS 39402-1372 | 2011-03-12 |
| 1922301860 | Huong Quynh Vu | Pharmacist | 5916 U S Highway 49, Hattiesburg, MS 39401-7577 | 2010-12-15 |
| 1043528508 | Timothy J Williamson | Pharmacist | 5266 Old Highway 11 Ste 160, Hattiesburg, MS 39402-7820 | 2010-09-18 |
| 1255644340 | Christina White | Pharmacist | 64 Old Airport Road Ste A, Hattiesburg, MS 39401 | 2010-07-19 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39402 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.