MISSISSIPPI CVS PHARMACY, L.L.C. (NPI# 1255647541) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255647541 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #04536 |
| Practice Address |
301 American Ave Booneville MS 38829-1001 |
| Mailing Address |
1 Cvs Dr Box 1075-pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 6627201707 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2010-08-24 |
| Last Update Date | 2011-01-13 |
| 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 | 01880069 | 05 | |
| NCPDP | 2588119 | 01 | |
| MS | MEDICAID DME | 07609070 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #04536 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 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 |
| 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 |
301 AMERICAN AVE |
| City | BOONEVILLE |
| State | MS |
| Zip Code | 38829-1001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962029249 | Ortho Express Holding Company, LLC | Clinic/Center | 608 W Church St, Booneville, MS 38829 | 2020-07-02 |
| 1073142600 | Chelsea Cara Mcmillin | Registered Nurse | 2014 C East Chambers Drive, Booneville, MS 38829 | 2020-04-06 |
| 1396210274 | Hooper Transportation LLC | Private Vehicle | 105 Jacinto Heights, No 2, Booneville, MS 38829 | 2018-10-08 |
| 1699251314 | John L Hooper | Driver | 105 Jacinto Heights No 2, Booneville, MS 38829 | 2018-07-16 |
| 1750744389 | Jeni Ramey | Social Worker | 214 Dogwood Estates, Booneville, MS 38829 | 2016-03-31 |
| 1770944977 | Judy Dillard | Peer Specialist | 2100 Chambers Drive, Booneville, MS 38829 | 2016-03-15 |
| 1508253295 | Mary Grace Hancock | Internal Medicine | 202 N 1st St Ste B, Booneville, MS 38829 | 2015-04-20 |
| 1508042722 | Mary Dean Stone | Registered Nurse | 2100 East Chamberss, Booneville, MS 38829 | 2008-01-17 |
| 1144406430 | Amy Cole | Registered Nurse | 2100 East Chambers, Booneville, MS 38829 | 2008-01-16 |
| 1972715118 | Rita D. Jones | Nurse Practitioner | 1907 South Lake Street, Booneville, MS 38829 | 2007-05-03 |
| Find all providers in zip 38829 | ||||
| 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 |
|---|---|---|---|---|
| 1811468952 | Davidson Pharmacy, LLC | Pharmacy | 203a N 2nd St, Booneville, MS 38829-2701 | 2018-12-16 |
| 1932274362 | Big World Drug Enterprises Inc | Pharmacy | 1531 East Main Street, Booneville, AR 72927 | 2006-11-21 |
| 1184736175 | Smee Drug Store Inc | Pharmacy | 32 W Main St, Booneville, AR 72927-3635 | 2006-08-31 |
| 1790837961 | Cox-blythe Drug Company | Pharmacy | 122 W College St, Booneville, MS 38829-3410 | 2007-01-17 |
| 1720192784 | Davidson Discount Pharmacy Inc | Pharmacy | 203 N 2nd St, Booneville, MS 38829-2701 | 2006-08-18 |
| 1245268200 | Freds Stores of Tennessee Inc | Pharmacy | 502 N 2nd St, Booneville, MS 38829-1721 | 2006-06-29 |
| 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 |
| 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 |
| 1992292536 | Mantachie Pharmacy LLC | Pharmacy | 3309 Highway 371 N, Mantachie, MS 38855 | 2018-04-19 |
| Find all providers with the same taxonomy | ||||
| City | BOONEVILLE |
| Zip Code | 38829 |
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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.