LOGAN KELLEY (NPI# 1033409669) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033409669 |
| Entity Type | Individual |
| Full Name | LOGAN KELLEY |
| Credential | PHARM. D |
| Practice Address |
2310 Clay St Vicksburg MS 39183-3123 |
| Mailing Address |
107 Ashford Dr Apt 2723 West Monroe LA 71291-7916 |
| Practice Telephone | 6016615856 |
| Enumeration Date | 2011-04-16 |
| Last Update Date | 2011-04-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 183500000X | Pharmacist | 018795 | LA | Pharmacy Service Providers |
| Y | 183500000X | Pharmacist | 010895 | MS | Pharmacy Service Providers |
| Street Address |
2310 CLAY ST |
| City | VICKSBURG |
| State | MS |
| Zip Code | 39183-3123 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962017830 | Zalak Mukesh Patel | Pharmacist | 2310 Clay St, Vicksburg, MS 39183-3123 | 2020-09-08 |
| 1164945374 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 2310 Clay St, Vicksburg, MS 39183 | 2017-07-19 |
| 1932512548 | Michelyn Patton | Pharmacist | 2310 Clay St, Vicksburg, MS 39183-3123 | 2014-06-11 |
| 1861805483 | Jonathan Fulton | Pharmacist | 2310 Clay St, Vicksburg, MS 39183-3123 | 2014-06-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306217823 | Tracy Curtis | Speech-Language Pathologist | 2100 Us 61, Vicksburg, MS 39183 | 2015-10-09 |
| 1649566894 | The Life Balance Clinic, Behavioral Health Service | Social Worker | 1107 B Openwood St., Vicksburg, MS 39183 | 2011-06-27 |
| 1245428788 | Melanie Joan Waldrop | Nurse Anesthetist, Certified Registered | 2100 Hwy 61n, River Region Medical Center, Vicksburg, MS 39183 | 2007-10-10 |
| 1871714477 | Robert Michael Coleman | Dentist | 2356 Grove Street, Vicksburg, MS 39183 | 2007-05-01 |
| 1942363502 | Visions Physical Therapy | Physical Therapist | 110 Holt Collier Dr, Vicksburg, MS 39183 | 2006-12-18 |
| 1023117991 | Janet S Fisher Dmd Pa | Dentist | 1212 Mission 66, Vicksburg, MS 39183 | 2006-09-21 |
| 1407878663 | Annette Bryant | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2006-07-24 |
| 1932168416 | Promise Hospital of Vicksburg Inc | Long Term Care Hospital | 2100 Highway 61 N Fl 6, Vicksburg, MS 39183 | 2006-03-22 |
| 1255777025 | Joyce Wanjugu Muruthi | Obstetrics & Gynecology | 2100 Highway 61 N, Vicksburg, MS 39183 | 2013-05-20 |
| 1811244858 | Life Balance Clinic LLC | Social Worker | 1107 Openwood St, Vicksburg, MS 39183 | 2012-08-09 |
| Find all providers in zip 39183 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093353047 | Virginia Leo Black | Pharmacist | 6010 Castle Rd, Vicksburg, MS 39180-9310 | 2019-12-19 |
| 1245706803 | Jacenta Matthews | Pharmacist | 1435 N Frontage Rd, Vicksburg, MS 39180-5170 | 2018-10-22 |
| 1225327588 | Kimberly Nicole Laws | Pharmacist | 3046 Indiana Ave, Vicksburg, MS 39180-5252 | 2011-04-06 |
| 1912132168 | Jo Lynne Kirchhoff | Pharmacist | 110 S. Main Streets, Vicksburg, MI 49097 | 2009-05-18 |
| 1770615353 | Dennis Mark Beaman | Pharmacist | 15047 Jimmy Dr, Vicksburg, MI 49097-9764 | 2007-03-10 |
| 1609952175 | Durst Discount Drugs, Inc | Pharmacist | 2122 Clay St, Vicksburg, MS 39183-3119 | 2006-10-27 |
| 1568548022 | Durst Discount Drugs, Inc. | Pharmacist | 3117 Halls Ferry Rd, Vicksburg, MS 39180-5109 | 2006-10-27 |
| 1447355607 | People's Drug Store Inc | Pharmacist | 1521 Washington St, Vicksburg, MS 39180-3539 | 2006-09-13 |
| 1467485839 | Colonial Discount Drugs | Pharmacist | 1017 Mission 66, Vicksburg, MS 39183-2753 | 2006-07-09 |
| 1922031392 | Corner Drug Store | Pharmacist | 1123 Washington St, Vicksburg, MS 39183-2959 | 2006-07-09 |
| Find all providers in VICKSBURG | ||||
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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.