MISSISSIPPI CVS PHARMACY, L.L.C. (NPI# 1144468802) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144468802 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #04997 |
| Practice Address |
305 Meadowbrook Rd. Jackson MS 39206 |
| Mailing Address |
1 Cvs Dr Woonsocket RI 02895-6146 |
| Practice Telephone | 4017651500 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2009-02-03 |
| Last Update Date | 2011-01-26 |
| 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 | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 2587561 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #04997 | 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 |
| 1861654733 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 1209 Sunset Dr, Grenada, MS 38901-4063 | 2008-07-01 |
| 1225213408 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 25820 W Main St, West Point, MS 39773-2763 | 2008-01-07 |
| Street Address |
305 MEADOWBROOK RD. |
| City | JACKSON |
| State | MS |
| Zip Code | 39206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023661824 | Latoya Lanette Trunell | Occupational Therapy Assistant | 787 East Northside Drive, Jackson, MS 39206 | 2019-07-20 |
| 1649839291 | Andrew Harris | Dentist | 4505 I-55 Frontage Rd. N, Jackson, MS 39206 | 2019-06-07 |
| 1679065916 | Savannah Lee Zachry | Physical Therapist | 5140 Galaxie Dr Ste 108, Jackson, MS 39206 | 2018-06-02 |
| 1669987723 | Harmony House Calls LLC | Nurse Practitioner | 5140 Galaxie Dr Ste 105, Jackson, MS 39206 | 2017-12-11 |
| 1841719903 | Yolanda Yvette Bell | Nurse Practitioner | 6064 Whitestone Rd, Jackson, MS 39206 | 2017-09-10 |
| 1760907117 | Anthony Brown Jr. | Physical Therapist | 5411 I-55 North, Jackson, MS 39206 | 2017-08-07 |
| 1114457132 | Ambric N Williams | Occupational Therapy Assistant | 6017 Whitestone Rd, Jackson, MS 39206 | 2017-06-13 |
| 1952835613 | Peak Chiropractic Care, LLC | Chiropractor | 4915 I-55 North, Suite 201b, Jackson, MS 39206 | 2017-04-19 |
| 1447798293 | Peterkin and Associates of Mississippi Inc | Community/Behavioral Health | 5155 Galaxie Drive, Suite F, Jackson, MS 39206 | 2017-02-01 |
| 1952844219 | Jennifer Penick | Counselor | 460 Briarwood Drive, Suite 510, Jackson, MS 39206 | 2016-11-18 |
| Find all providers in zip 39206 | ||||
| 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.