JAMES EDDLEMON (NPI# 1720626161) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720626161 |
| Entity Type | Individual |
| Full Name | JAMES EDDLEMON |
| Practice Address |
465 Stateline Rd W Southaven MS 38671-1611 |
| Mailing Address |
8814 Beatline Rd Tunica MS 38676-9603 |
| Practice Telephone | 6623933426 |
| Mailing Telephone | 9015681102 |
| Enumeration Date | 2019-12-17 |
| Last Update Date | 2020-03-10 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 07251 | MS | Pharmacy Service Providers |
| Y | 1835P0018X |
Pharmacist Specialization: Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
07251 | MS | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 1720626161 | 05 |
| Street Address |
465 STATELINE RD W |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-1611 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275567042 | Kroger Limited Partnership I | Durable Medical Equipment & Medical Supplies | 465 Stateline Rd W, Southaven, MS 38671-1611 | 2006-07-10 |
| 1356637524 | Douglas Edward Gardner | Pharmacist | 465 Stateline Rd W, Southaven, MS 38671-1611 | 2011-06-25 |
| 1134415532 | Shaula M Hailey | Pharmacist | 465 Stateline Rd W, Southaven, MS 38671-1611 | 2011-06-23 |
| 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 | 1835P0018X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
| Pharmacist Clinician/Clinical Pharmacy Specialist is a pharmacist with additional training and an expanded scope of practice that may include prescriptive authority, therapeutic management, and disease management. |
| Notes: Source: National Uniform Claim Committee, 2007 [1/1/2008: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093354649 | Kenneth Bradley Bush II | Pharmacist | 3095 Goodman Rd E, Southaven, MS 38672-8707 | 2019-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467085274 | Kenneth Martin | Pharmacist | 1811 West Govt St, Brandon, MS 39042-2106 | 2020-02-20 |
| 1316585581 | Deborah Magoun Rosenbaum | Pharmacist | [email protected], 4910 I-55 North, Jackson, MS 39211 | 2019-12-18 |
| 1326686932 | Joshua Brett Manning | Pharmacist | Kroger, 2340 Highway 15 N, Laurel, MS 39440-1831 | 2019-12-13 |
| 1023585296 | Brenda M Wise | Pharmacist | 301 Fisher St # 2b, Biloxi, MS 39534-2508 | 2018-10-25 |
| 1508311028 | Koshy Mathew | Pharmacist | 122 Mcdill Cv, Madison, MS 39110-6562 | 2016-08-25 |
| 1992106413 | Roland Mullins Jr. | Pharmacist | 301 Fisher St Rm 309b, Keesler Afb, MS 39534-2508 | 2014-09-16 |
| 1124432679 | Tara Lynn Felder | Pharmacist | 1121 Hwy 98/51, Summit, MS 39666 | 2014-06-12 |
| 1912333956 | Carman G Cochran | Pharmacist | 68 Buffalo Rd, Mc Lain, MS 39456-2330 | 2013-09-23 |
| 1902239197 | Melanie Hammill Bishop | Pharmacist | 427 Ms Highway 51 North, Brookhaven, MS 39601 | 2013-08-12 |
| 1578833299 | April Malone | Pharmacist | 208 S 27th Ave, Hattiesburg, MS 39401-7173 | 2012-01-11 |
| 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.