CITY DRUG STORE OF HAZLEHURST, INC. (NPI# 1467532663) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467532663 |
| Entity Type | Organization |
| Organization Name | CITY DRUG STORE OF HAZLEHURST, INC. |
| Other Organization Name | ROSE'S SUPER DISCOUNT DRUGS |
| Practice Address |
218 Caldwell Dr Hazlehurst MS 39083-2712 |
| Practice Telephone | 6018941222 |
| Practice Fax Number | 6018941522 |
| Mailing Telephone | 6018941222 |
| Mailing Fax Number | 6018941522 |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2008-06-20 |
| Authorized Official Name | MR. MICHAEL HENRY ROSE (OWNER) |
| Authorized Official Telephone | 6018941222 |
| Authorized Official Credential | R. PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251K00000X | Public Health or Welfare | 002093 | MS | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00030881 | 05 |
| Other Name | Type Code |
|---|---|
| Rose's Super Discount Drugs | Doing Business As Name - Organization |
| Street Address |
218 CALDWELL DR |
| City | HAZLEHURST |
| State | MS |
| Zip Code | 39083-2712 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639520125 | Andrea Johns | Pharmacy Technician | 218 Caldwell Dr, Hazlehurst, MS 39083-2712 | 2016-06-25 |
| 1568683993 | Vicki B. Johns | Pharmacist | 218 Caldwell Dr, Hazlehurst, MS 39083-2712 | 2007-05-02 |
| 1447471842 | Kathleen Mary Rose | Pharmacist | 218 Caldwell Dr, Hazlehurst, MS 39083-2712 | 2007-05-01 |
| 1265653661 | Michael Henry Rose | Pharmacist | 218 Caldwell Dr, Hazlehurst, MS 39083-2712 | 2007-05-01 |
| 1962623371 | Troy Donald Douglas | Pharmacist | 218 Caldwell Dr, Hazlehurst, MS 39083-2712 | 2007-05-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235757949 | Claiborne Brooke White | Speech-Language Pathologist | 27190 Ms-28, Hazlehurst, MS 39083 | 2020-07-09 |
| 1750898961 | Laquita L. Johnson | Pharmacist | 102 Williams Street, Hazlehurst, MS 39083 | 2018-01-09 |
| 1134633324 | Enduracare Acute Care Services LLC | Clinic/Center | 236 North Caldwell Drive, Hazelhurst, MS 39083 | 2017-11-27 |
| 1053852392 | Alvin Dale Griffin | Occupational Therapy Assistant | 27190 Ms 28, Hazlehurst, MS 39083 | 2017-03-20 |
| 1770609364 | Gerri L Hill Chance | Psychiatry & Neurology | 206 Robert Mcdaniel Drive, Hazelhurst, MS 39083 | 2007-03-22 |
| 1902976665 | Allred's Pharmacy Inc | Pharmacy | 214 West Gallatin St, Hazelhurst, MS 39083 | 2006-11-09 |
| 1891897260 | Fred J Mcdonnell | Family Medicine | 213 Caldwell Drive, Hazlehurst, MS 39083 | 2006-09-05 |
| 1770515058 | Central Mississippi Civic Improvement Association | Clinic/Center | 550 Caldwell Drive, Hazlehurst, MS 39083 | 2006-07-07 |
| 1881649168 | Isd Renal Inc | Clinic/Center | 201 N Haley St, Hazlehurst, MS 39083 | 2006-05-24 |
| 1396793188 | Hazlehurst Vision Clinic | Optometrist | 247 North Caldwell Dr., Suite B, Hazlehurst, MS 39083 | 2006-05-04 |
| Find all providers in zip 39083 | ||||
| Taxonomy Code | 251K00000X |
| Grouping | Agencies |
| Classification | Public Health or Welfare |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184653479 | Jeff Davis County Board of Health | Public Health or Welfare | 30 E Sycamore St, Hazlehurst, GA 31539-6162 | 2006-07-01 |
| 1386054732 | Mississippi State Department of Health | Public Health or Welfare | 640 Georgetown St, Hazlehurst, MS 39083-2501 | 2014-05-06 |
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|---|---|---|---|---|
| 1861024747 | Second Chance Outreach Learning Center | Public Health or Welfare | 4807 N State St Ste 407, Jackson, MS 39206-4826 | 2020-02-07 |
| 1184152233 | Tier-3 Solutions, Inc. | Public Health or Welfare | 5255 Keele St Ste C, Jackson, MS 39206-4381 | 2017-06-01 |
| 1609262955 | South Mississippi Aids Task Force, Inc. | Public Health or Welfare | 2756 Fernwood Rd, Biloxi, MS 39531-3520 | 2015-04-14 |
| 1750786158 | Mississippi Department Health | Public Health or Welfare | 1141 Bayview Ave Ste 102, Biloxi, MS 39530-1651 | 2014-10-28 |
| 1316358914 | Mississippi State Department of Health | Public Health or Welfare | 110 Cross Park Dr, Suite C, Pearl, MS 39208-9016 | 2014-05-16 |
| 1265843809 | Mississippi State Department | Public Health or Welfare | 209 S Pleasant St, Charleston, MS 38921-2325 | 2014-05-16 |
| 1366853004 | Mississippi State Department of Health | Public Health or Welfare | 3276 Lynch St, Jackson, MS 39209-7205 | 2014-05-15 |
| 1952712630 | Mississippi State Department of Health | Public Health or Welfare | 140 W Mill Road, Bude, MS 39630-7036 | 2014-05-15 |
| 1285045955 | Mississippi State Department of Health | Public Health or Welfare | 7547 Highway 11, Carriere, MS 39426-8904 | 2014-05-15 |
| 1972914653 | Mississippi State Department of Health | Public Health or Welfare | 1000 Irene Street, Liberty, MS 39645-5193 | 2014-05-15 |
| Find all providers with the same taxonomy | ||||
| City | HAZLEHURST |
| Zip Code | 39083 |
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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.