MISSISSIPPI CVS PHARMACY, L.L.C. (NPI# 1255561916) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255561916 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #08994 |
| Practice Address |
2955 Church Rd E Southaven MS 38671-9767 |
| Mailing Address |
1 Cvs Dr Box 1075 - Pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 6623497375 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2009-07-16 |
| 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 |
|---|---|---|---|
| MS | MEDICAID DME | 04086719 | 01 |
| NCPDP # | 2587701 | 01 | |
| MS | 02857220 | 05 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #08994 | 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 |
| 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 |
| 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 |
2955 CHURCH RD E |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-9767 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| 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 |
|---|---|---|---|---|
| 1831115781 | Southern Home Care | Pharmacy | 8865 First Industrial Dr, Southaven, MS 38671-1919 | 2006-07-14 |
| 1164454104 | Freds Stores of Tennessee Inc | Pharmacy | 8912 Office Park Plaza Dr, Southaven, MS 38671 | 2006-07-07 |
| 1659746584 | Proxsys Rx - Rush LLC | Pharmacy | 7601 Southcrest Pkwy, Southaven, MS 38671-4739 | 2015-12-03 |
| 1619396892 | Complete Diabetes Pharmacy Care Inc | Pharmacy | 7165 Swinnea Rd, Bldg B-2, Southaven, MS 38671-6360 | 2014-04-15 |
| 1275697435 | Lincare Pharmacy Services Inc. | Pharmacy | 1235 Main Street, Southaven, MS 38671-1429 | 2006-12-21 |
| 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 | ||||
Please comment or provide details below to improve the information on MISSISSIPPI CVS PHARMACY, L.L.C..
| 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.