MISSISSIPPI CVS PHARMACY, L.L.C. (NPI# 1780783092) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780783092 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY # 05865 |
| Practice Address |
112 Stribling Ln Brandon MS 39042-6600 |
| Mailing Address |
1 Cvs Dr Po Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6016647226 |
| Practice Fax Number | 6018243006 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2011-01-26 |
| 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 | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | 01537/01.2 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 000330328 | 05 | |
| OTHER ID NUMBER-COMMERCIAL NUMBER | 2512374 | 01 |
| Other Name | Type Code |
|---|---|
| CVS PHARMACY # 05865 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255647541 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 301 American Ave, Booneville, MS 38829-1001 | 2010-08-24 |
| 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 |
| Street Address |
112 STRIBLING LN |
| City | BRANDON |
| State | MS |
| Zip Code | 39042-6600 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740821529 | Claudia Francis Jones | Technician | 1008 Greenfield Circle, Brandon, MS 39042 | 2019-10-03 |
| 1194294546 | Allen Keith Johnson Jr. | Counselor | 1700 West Government Street Building B. Suite O., Brandon, MS 39042 | 2018-11-15 |
| 1689167462 | Regional Home Care and Infusions, Inc. | Registered Nurse | 302 Town Square, Suite 110, Brandon, MS 39042 | 2018-06-07 |
| 1013419563 | Brandon Family Chiropractic LLC | Chiropractor | 1350 West Government Street Suite A1, Brandon, MS 39042 | 2018-03-01 |
| 1184146789 | Lakeland Home Program LLC | Clinic/Center | 209 Mar Lyn Dr, Brandon, MS 39042 | 2017-07-14 |
| 1104275510 | Matthew Logue | Community Health Worker | 2009 Mossy Cove, Brandon, MS 39042 | 2016-06-07 |
| 1932569704 | Haley Wilson | Chiropractor | 1350 W Government St Ste A1, Brandon, MS 39042 | 2016-03-07 |
| 1548698608 | St Dominic Medical Associates LLC | Family Medicine | 1297 West Government Street, Brandon, MS 39042 | 2013-10-28 |
| 1760825434 | Linda J. Bridges | Respiratory Therapist, Certified | 330 Rankin Road, Brandon, UNITED STATES 39042 | 2013-04-12 |
| 1861739922 | Georgia Christine Shirley | Nurse Practitioner | 2008 Brookstone Place, Brandon, MS 39042 | 2013-01-09 |
| Find all providers in zip 39042 | ||||
| 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 |
|---|---|---|---|---|
| 1972893006 | Gw Pharmacy LLC | Pharmacy | 201 N College St Ste 101, Brandon, MS 39042-4439 | 2011-04-11 |
| 1033437223 | Wullstein Pharmacy Inc. | Pharmacy | 116 E Holly Blvd, Brandon, SD 57005-1114 | 2010-05-12 |
| 1003145079 | Value Rx LLC | Pharmacy | 141 N Oakwood Ave, Brandon, FL 33510-4629 | 2009-12-21 |
| 1083942924 | Optum Pharmacy 601, LLC | Pharmacy | 1070 E Brandon Blvd, Brandon, FL 33511-5509 | 2009-12-04 |
| 1306097902 | Polk's Crossgate Discount Drugs Inc. | Pharmacy | 1031 Star Rd, Brandon, MS 39042-9010 | 2008-10-02 |
| 1437328986 | Kabs of Brandon Inc | Pharmacy | 759 W Brandon Blvd, Brandon, FL 33511-4901 | 2008-02-28 |
| 1063584845 | Kaasindra & Co Inc | Pharmacy | 216 Oakfield Dr, Brandon, FL 33511-5707 | 2006-11-15 |
| 1225109820 | Brandon Discount Drugs Inc | Pharmacy | 200 Tamberline St, Brandon, MS 39042-3162 | 2006-11-13 |
| 1700975323 | Lewis Drugs, Inc. | Pharmacy | 115 N Splitrock Blvd, Brandon, SD 57005-1529 | 2006-10-12 |
| 1548207079 | Albertsons LLC | Pharmacy | 610 E Brandon Blvd, Brandon, FL 33511-5421 | 2006-06-01 |
| Find all providers in BRANDON | ||||
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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.