MISSISSIPPI CVS PHARMACY, L.L.C. (NPI# 1144329459) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144329459 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY # 05745 |
| Practice Address |
2803 Suncrest Dr Jackson MS 39212-2529 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6013732111 |
| Practice Fax Number | 6013727846 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2012-03-01 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | 00815/01.2 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2501129 | 01 | |
| MS | 000330336 | 05 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY # 05745 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255647541 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 301 American Ave, Booneville, MS 38829-1001 | 2010-08-24 |
| 1508179888 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 205 Highway 16 West, Carthage, MS 39051 | 2010-07-15 |
| 1063734291 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 135 Highway 15 N, Pontotoc, MS 38863-1914 | 2010-02-15 |
| 1093046500 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 5025 Highway 305 N, Olive Branch, MS 38654-3602 | 2010-01-22 |
| 1255561916 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2955 Church Rd E, Southaven, MS 38671-9767 | 2009-07-16 |
| 1720217524 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 7363 Goodman Rd, Olive Branch, MS 38654-1906 | 2009-07-14 |
| 1417183922 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2945 Goodman Road East, Southaven, MS 38672 | 2009-06-10 |
| 1437393311 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 55 Goodman Rd W, Southaven, MS 38671-9447 | 2009-04-23 |
| 1144468802 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 305 Meadowbrook Rd., Jackson, MS 39206 | 2009-02-03 |
| 1861654733 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1209 Sunset Dr, Grenada, MS 38901-4063 | 2008-07-01 |
| Street Address |
2803 SUNCREST DR |
| City | JACKSON |
| State | MS |
| Zip Code | 39212-2529 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013406172 | South Central Community Action Agency, Inc | Non-emergency Medical Transport (VAN) | 3891 I-55 South Frontage Rd, Jackson, MS 39212 | 2018-05-04 |
| 1508305780 | Caring Companions LLC | Home Health | 1024 Cooper Rd, Jackson, MS 39212 | 2017-02-21 |
| 1750634044 | Christians In Action, Inc. | Community/Behavioral Health | 2025 North Siwell Rd, Jackson, MS 39212 | 2012-10-24 |
| 1609164748 | Counseling and Mentoring Program | Community/Behavioral Health | 2964 Terry Road B-1, Jackson, MS 39212 | 2011-07-11 |
| 1407179039 | Caring Hands Community Services Inc | Skilled Nursing Facility | 3318 Longwood Drive, Jackson, MS 39212 | 2010-03-10 |
| 1992239404 | Shaemik Harris | Registered Nurse | 3520 Sykes Park Dr, Jackson, MS 39212 | 2017-04-12 |
| 1780044438 | Alfonzo Haralson | Counselor | 132 Thousand Oaks Cir, Jackson, MS 39212-2046 | 2016-02-24 |
| 1659384063 | Kentrell Marie Liddell | Family Medicine | 2104 Thousand Oaks Dr, Jackson, MS 39212-2048 | 2006-08-15 |
| 1649819590 | George Cavett Jr. | Nurse Practitioner | 2450 Twisted Oak Dr, Jackson, MS 39212-2137 | 2019-12-24 |
| 1912455361 | Victorious Healthcare L.L.C. | Assisted Living Facility | 4959 Laurel Oak Dr, Jackson, MS 39212-2150 | 2016-09-14 |
| Find all providers in zip 39212 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| Notes: Source: Developed by National Council for Prescription Drug Programs (NCPDP), National Home Infusion Association (NHIA), and Pharmacist Services Technical Advisory Coalition (PSTAC) [1/1/2006: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942847413 | Southeast Hospital | Pharmacy | 2600 E. Main Street, Suite 113, Jackson, MO 63755 | 2019-12-04 |
| 1912409475 | Moyes Pharmacy Inc | Pharmacy | 227 S Mulberry St, Jackson, GA 30233-2058 | 2018-03-01 |
| 1619410321 | Red Cap Pharmacy 001 LLC | Pharmacy | 214 N West Ave Ste A, Jackson, MI 49201-1903 | 2016-11-29 |
| 1285050864 | Lewis Family Drug, LLC | Pharmacy | 825 3rd St, Jackson, MN 56143-1187 | 2014-03-06 |
| 1356664239 | Stone Drug | Pharmacy | 830 W Broadway, Jackson, WY 83002-9000 | 2010-03-08 |
| 1215053061 | Country Market Pharmacies, L.L.C. | Pharmacy | 1410 W Ganson St, Jackson, MI 49202-4063 | 2007-03-22 |
| 1851467823 | Costplus Pharmacy | Pharmacy | 104a W University Pkwy, Jackson, TN 38305-1635 | 2006-11-28 |
| 1205909777 | Brookshire Grocery Company | Pharmacy | 2861 Terry Rd, Attention Pharmacy Dept, Jackson, MS 39212-3051 | 2006-11-15 |
| 1396818860 | Brookshire Grocery Company | Pharmacy | 5841 Ridgewood Rd, Attention Pharmacy Dept, Jackson, MS 39211-2618 | 2006-11-15 |
| 1861564486 | Brents Drugs of Belhaven | Pharmacy | 902b E Fortification St, Jackson, MS 39202 | 2006-11-15 |
| Find all providers in JACKSON | ||||
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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.