REGION IV DESOTO COUNTY PHARMACY (NPI# 1689915423) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1689915423 |
| Entity Type | Organization |
| Organization Name | REGION IV DESOTO COUNTY PHARMACY |
| Practice Address |
2705 Highway 51 S Hernando MS 38632-2634 |
| Practice Telephone | 6624494025 |
| Practice Fax Number | 6624293546 |
| Mailing Telephone | 6622869883 |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2016-10-06 |
| Authorized Official Name | CHARLIE SPEARMAN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 6622869883 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers |
| Street Address |
2705 HIGHWAY 51 S |
| City | HERNANDO |
| State | MS |
| Zip Code | 38632-2634 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841339512 | James O White | Public Health or Welfare | 2705 Highway 51 S, Desoto County Health Dept., Hernando, MS 38632-2634 | 2007-02-06 |
| 1174165435 | Arkeshia Ware | Counselor | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2019-10-08 |
| 1982256343 | Shakisa Richardson | Case Manager/Care Coordinator | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2019-07-15 |
| 1518426162 | Renee Elizabeth Reichert | Registered Nurse | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2019-03-13 |
| 1588130041 | Hannah Herndon | Nurse Practitioner | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2018-10-22 |
| 1760961957 | Semeca Fanchon Mclawyer | Counselor | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2018-08-09 |
| 1659850899 | Cormelanie Shondell Chillous | Counselor | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2018-08-08 |
| 1821580598 | Joy Delony Traylor | Counselor | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2018-05-30 |
| 1396110847 | Samantha Minyard | Counselor | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2015-12-09 |
| 1124403498 | Ngeche Gang | Counselor | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2015-07-28 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275042335 | Dominic Lashay Freeman | Case Management | 2744 Hwy 51 South, Hernando, MS 38632 | 2017-09-21 |
| 1851814875 | Staci Lea Hudson | Nurse Practitioner | 2705 Hwy 51 South, Hernando, MS 38632 | 2017-07-21 |
| 1629425517 | Jamieka Harris | Counselor | 2705 Hwy 51 S, Hernando, MS 38632 | 2016-05-20 |
| 1215302476 | Elizabeth Claire Corban | Counselor | 2725 Highway 51 S., Hernando, MS 38632 | 2015-12-14 |
| 1669850004 | Jcc, LLC | Dentist | 1150 Monteith Avenue, Suite 102, Hernando, MS 38632 | 2015-05-18 |
| 1053701995 | Leigh Houston | Registered Nurse | 3104 Stonehenge Dr, Hernando, MS 38632 | 2015-01-30 |
| 1871831552 | Hernando Dental Group Incorporated | Dentist | 2264 Mcingvale Rd., Hernando, MS 38632 | 2013-01-30 |
| 1255677001 | Midsouth Medical Specialties, LLC | Pharmacy | 2260 Highway 515 South, Hernando, MS 38632 | 2012-12-26 |
| 1447506514 | Surgical First Assist, LLC | Specialist/Technologist, Other | 8921 Black Panther Cove, Herenando, MS 38632 | 2012-07-26 |
| 1629348396 | Stacy Riddle-mattox | Counselor | 2725 Highway 51 South, Hernando, MS 38632 | 2012-01-11 |
| Find all providers in zip 38632 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1417090093 | University Pavilion Pharmacy | Pharmacy | 1410 E Woodrow Wilson Dr, Jackson, MS 39216 | 2007-02-14 |
| 1518040500 | Region Iv Mh Mr Commission Phcy | Pharmacy | 2301b E Chambers Dr, Booneville, MS 38829 | 2006-10-23 |
| 1295268985 | Southern Pharmacy Clinical Management | Pharmacy | 3224 Dijon Ave, Ocean Springs, MS 39564-8520 | 2017-04-10 |
| 1912452921 | Sports Medicine Pharmacy LLC | Pharmacy | 1325 E Fortification St, Jackson, MS 39202-2442 | 2016-08-19 |
| 1689039711 | River Region Health System | Pharmacy | 2100 Highway 61 N, Pharmacy, Vicksburg, MS 39183-8211 | 2015-12-16 |
| 1891171351 | Prime Urgent Medical Clinic | Pharmacy | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2015-08-07 |
| 1578956264 | Alliance Healthcare System | Pharmacy | 1938 Crescent Meadows Dr, Holly Springs, MS 38635-7419 | 2015-03-05 |
| 1871927517 | Southeast Mississippi Rural Health Initiative, Inc. | Pharmacy | 62 Old Airport Rd, Hattiesburg, MS 39401-8382 | 2013-08-29 |
| 1740417922 | Coastal Family Health Center, Inc. | Pharmacy | 1025 Division St, Ste A, Biloxi, MS 39530-2906 | 2009-06-16 |
| 1508072273 | Foot Solutions LLC | Pharmacy | 120 Market St, Woodland, MS 39776-9104 | 2007-05-16 |
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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.