SUMRALL DRUG STORE LLC (NPI# 1275613952) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275613952 |
| Entity Type | Organization |
| Organization Name | SUMRALL DRUG STORE LLC |
| Other Organization Name | SUMRALL DRUG STORE |
| Practice Address |
1109 Hwy 42 Sumrall MS 39482-0246 |
| Mailing Address |
Po Box 120 Sumrall MS 39482-0120 |
| Practice Telephone | 6017584243 |
| Practice Fax Number | 6017584999 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2016-12-07 |
| Authorized Official Name | BEAU HADEN (OWNER) |
| Authorized Official Telephone | 6017584243 |
| Authorized Official Credential | PHARMD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
00461011 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 0092193 | 05 | |
| PK | 2047304 | 01 |
| Other Name | Type Code |
|---|---|
| SUMRALL DRUG STORE | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366004731 | Sumrall Drug Store LLC | Pharmacy | 1109 Hwy 42, Sumrall, MS 39482 | 2019-07-05 |
| Street Address |
1109 HWY 42 |
| City | SUMRALL |
| State | MS |
| Zip Code | 39482-0246 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871128934 | Brandon Scott Nesler | Pharmacist | 1109 Hwy 42, Sumrall, MS 39482 | 2020-03-10 |
| 1366004731 | Sumrall Drug Store LLC | Pharmacy | 1109 Hwy 42, Sumrall, MS 39482 | 2019-07-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891255295 | Southern Saferide Transportation | Non-emergency Medical Transport (VAN) | 309 Hr Watts Road, Sumrall, MS 39482 | 2019-03-21 |
| 1346598380 | Serene Adult Care | Technician | 261 H.r. Watts Rd, Sumrall, MS 39482 | 2012-08-23 |
| 1346472628 | Patsy K Mcgrew | Counselor | 14 Ravenwood Lane, Sumrall, MS 39482 | 2009-08-20 |
| 1952572919 | Brett Alan Valentine D.m.d. | Dentist | 4864-b Hwy 589, Sumrall, MS 39482 | 2008-03-18 |
| 1205924834 | Medical Plus, LLC | Durable Medical Equipment & Medical Supplies | 4 Preston St, Sumrall, MS 39482 | 2006-10-10 |
| 1396844734 | Brett A Valentine | Dentist | 4864 B Hwy 589, Sumrall, MS 39482 | 2006-09-22 |
| 1881703429 | Kimberly R Schramm | Physical Therapist | 1240 Highway 42, Sumrall, MS 39482 | 2006-08-29 |
| 1942217757 | John David Bullock | Family Medicine | 1238 Highway 42, Sumrall, MS 39482 | 2006-08-02 |
| 1326524646 | Jamie Elaine Thornton | Nurse Practitioner | 1238 Highway 42, Sumrall, MS 39482 | 2018-07-19 |
| 1598146136 | Hattiesburg Clinic, Pa | Physical Therapist | 1240 Highway 42, Sumrall, MS 39482 | 2015-06-09 |
| Find all providers in zip 39482 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124679873 | Family Drug Mart of Sumrall, LLC | Pharmacy | 4233 Rocky Branch Rd Ste B, Sumrall, MS 39482-4142 | 2019-09-24 |
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| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| 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.