MISSISSIPPI CVS PHARMACY LLC (NPI# 1174798417) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1174798417 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY # 03426 |
| Practice Address |
6040 Goodman Rd Walls MS 38680 |
| Mailing Address |
1 Cvs Dr Box 1075- Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 4017651500 |
| Mailing Telephone | 4017651500 |
| Mailing Fax Number | 4017707108 |
| Enumeration Date | 2008-04-28 |
| Last Update Date | 2011-10-25 |
| 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 | 2587181 | 01 | |
| MS | 06773354 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy # 03426 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740682210 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1435 N. Frontage Rd, Vicksburg, MS 39180-5170 | 2014-09-16 |
| 1710314463 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 365 Cole Rd, Hattiesburg, MS 39402 | 2013-09-26 |
| 1770826158 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 801 Highway 80 E, Clinton, MS 39056-5252 | 2013-04-03 |
| 1942562533 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12024 Lamey Bridge Rd, Diberville, MS 39540-8906 | 2012-06-11 |
| 1922366756 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1912 Jackson Ave W, Oxford, MS 38655-4454 | 2012-04-30 |
| 1356618979 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 800 E Fifteenth St, Yazoo City, MS 39194-7625 | 2011-11-28 |
| 1366735185 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2507 Hardy St, Hattiesburg, MS 39401-5914 | 2011-05-26 |
| 1598054082 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 750 City Ave S, Ripley, MS 38663-2520 | 2011-04-05 |
| 1730311689 | Mississippi Cvs Pharmacy LLC | Pharmacy | 3867 Promenade Pkwy, Diberville, MS 39540-5372 | 2009-08-11 |
| 1528229614 | Mississippi Cvs Pharmacy LLC | Pharmacy | 5150 Goodman Rd, Olive Branch, MS 38654-7903 | 2008-06-20 |
| Street Address |
6040 GOODMAN RD |
| City | WALLS |
| State | MS |
| Zip Code | 38680 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861928541 | Metro Treatment of Mississippi Lp | Clinic/Center | 8900 Delta Bluffs Cove, Walls, MS 38680 | 2017-05-02 |
| 1144625369 | Christian Muenyi | Pharmacist | 5840 Cedar Lake Drive N, Walls, MS 38680 | 2014-10-30 |
| 1407969330 | City of Horn Lake | Ambulance | 6363 Highway 301, Walls, MS 38680 | 2006-08-16 |
| 1093203978 | Adrian Hall | Counselor | 8900 Delta Bluffs Cove, Walls, MS 38680 | 2018-04-26 |
| 1194213132 | Alicia Nicole Danley | Counselor | 8900 Delta Bluff Cv, Walls, MS 38680-4400 | 2018-04-25 |
| 1508354945 | Ishita Pareek | Counselor | 8900 Delta Bluff Cv, Walls, MS 38680-4400 | 2018-05-01 |
| 1417570029 | Vrf Eye Specialty Group, Plc | Ophthalmology | 5800 Delta View Rd, Walls, MS 38680-8341 | 2020-05-19 |
| 1790249076 | Curstin Deneen Temes | Occupational Therapy Assistant | 7748 Tucker Dr, Walls, MS 38680-8579 | 2019-01-30 |
| 1487041364 | A.d.l. Transportation LLC | Non-emergency Medical Transport (VAN) | 7753 Bailee Ln, Walls, MS 38680-8580 | 2015-04-19 |
| 1154787646 | Compassionate Hearts Home Care Services, LLC | In Home Supportive Care | 7746 Mccarson Ln, Walls, MS 38680-9553 | 2016-01-13 |
| Find all providers in zip 38680 | ||||
| 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 |
|---|---|---|---|---|
| 1457973067 | Thomas Street Compounding Pharmacy | Pharmacy | 115 N Thomas St Ste G, Tupelo, MS 38801-3082 | 2020-05-18 |
| 1013558824 | Downhome Pharmacy, Inc. | Pharmacy | 606 W. Broad St, Monticello, MS 39654 | 2019-10-02 |
| 1356997985 | Sonshine Pharmacy, LLC | Pharmacy | 2745 Highway 371 N, Mantachie, MS 38855 | 2019-08-09 |
| 1699331868 | Fulton Specialty Pharmacy, LLC | Pharmacy | 1509 S Adams St Ste D, Fulton, MS 38843-6621 | 2019-05-14 |
| 1063971539 | National Pharmacy of Mississippi, LLC | Pharmacy | 371b Highland Colony Pkwy, Ridgeland, MS 39157-6035 | 2019-03-14 |
| 1811468952 | Davidson Pharmacy, LLC | Pharmacy | 203a N 2nd St, Booneville, MS 38829-2701 | 2018-12-16 |
| 1346710720 | Tupelo Specialty Pharmacy, LLC | Pharmacy | 1056 Cliff Gookin Blvd Ste C, Tupelo, MS 38801-6458 | 2018-11-28 |
| 1205302254 | A & A Infusion & Specialty, LLC | Pharmacy | 423 Mcallister St, Greenville, MS 38701-4704 | 2018-10-17 |
| 1306325402 | Family Drug Mart of Poplarville,llc | Pharmacy | 100 Highway 11 N, Poplarville, MS 39470-2217 | 2018-08-09 |
| 1851883789 | Amory Discount Pharmacy, LLC | Pharmacy | 60379 Cotton Gin Port Rd Ste B, Amory, MS 38821-7204 | 2018-06-06 |
| Find all providers with the same taxonomy | ||||
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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.