MEDI MART PHARMACIES OF MISSISSIPPI, INC. (NPI# 1043304033) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043304033 |
| Entity Type | Organization |
| Organization Name | MEDI MART PHARMACIES OF MISSISSIPPI, INC. |
| Other Organization Name | MEDI MART PHARMACY |
| Practice Address |
3737 Main St Moss Point MS 39563-5107 |
| Practice Telephone | 2284741011 |
| Practice Fax Number | 2284741033 |
| Mailing Telephone | 2284741011 |
| Mailing Fax Number | 2284741033 |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | MR. CLARENCE E. DUBOSE SR. (PRESIDENT) |
| Authorized Official Telephone | 2284741011 |
| Authorized Official Credential | R.PH. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
01148/01.1 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00030113 | 05 |
| Other Name | Type Code |
|---|---|
| Medi Mart Pharmacy | Doing Business As Name - Organization |
| Street Address |
3737 MAIN ST |
| City | MOSS POINT |
| State | MS |
| Zip Code | 39563-5107 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003038894 | Clarence E. Dubose Sr. | Pharmacist | 3737 Main St, Moss Point, MS 39563-5107 | 2007-05-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215596713 | Emmanuel Transit, LLC | Non-emergency Medical Transport (VAN) | 4337 Terrace Drive, Moss Point, MS 39563 | 2019-06-08 |
| 1134628985 | Kendra S Gardner | Nurse Practitioner | 3702 Jefferson St, Pascagoula, MS 39563 | 2018-02-07 |
| 1386186591 | Alice Smith | Counselor | 5007 Jefferson Street, Moss Point, MS 39563 | 2016-11-07 |
| 1508897000 | Coastal Family Health Center, Inc. | Clinic/Center | 4913 Weems Street, Moss Point, MS 39563 | 2006-07-05 |
| 1417988916 | Coastal Family Health Center | Clinic/Center | 6602 Orange Grove Road, Moss Point, MS 39563 | 2006-07-05 |
| 1285107466 | Miller Pharmacy | Pharmacy | 7818 Highway 613, Moss Point, MS 39563 | 2019-01-09 |
| 1629203153 | Clifford James Cook | Dentist | 4100 Mcinnis Ave, Moss Point, MS 39563-0000 | 2009-05-28 |
| 1518172568 | Moss Point Family Clinic | Clinic/Center | 5430 Griffin St, Moss Point, MS 39563-2003 | 2007-05-13 |
| 1376157487 | Rebekah N Stallworth | Nurse Practitioner | 5200 Griffin St, Moss Point, MS 39563-2020 | 2020-09-04 |
| 1871073403 | Elizabeth Adair Beatty | Pharmacist | 4231 Dantzler St, Moss Point, MS 39563-2217 | 2018-08-14 |
| Find all providers in zip 39563 | ||||
| Taxonomy Code | 3336C0003X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Community/Retail Pharmacy |
| A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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 |
|---|---|---|---|---|
| 1003991977 | Burnham-mckinney Pharmacies, Inc. #2 | Pharmacy | 7709 Highway 613, Moss Point, MS 39562 | 2006-10-26 |
| 1285107466 | Miller Pharmacy | Pharmacy | 7818 Highway 613, Moss Point, MS 39563 | 2019-01-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164038485 | Quinn's Family Pharmacy of Newton | Pharmacy | 193 Northside Dr, Newton, MS 39345-9523 | 2020-09-22 |
| 1194339275 | Friendship, LLC | Pharmacy | 4123 W Main St, Tupelo, MS 38801 | 2020-09-04 |
| 1649883844 | Natchez Wellness Pharmacy | Pharmacy | 29 Sergeant Prentiss Dr Ste 5, Natchez, MS 39120-4743 | 2020-08-26 |
| 1952910366 | Ct Stamps Inc | Pharmacy | 206 Marion Avenue, Mccomb, MS 39648 | 2020-07-31 |
| 1114566122 | Valley Drugs, Inc. | Pharmacy | 327b S Main St, Water Valley, MS 38965-3318 | 2019-12-23 |
| 1851939318 | Smith Pharmacy, Inc. | Pharmacy | 306 Northside Drive, Newton, MS 39345 | 2019-12-16 |
| 1285270801 | Proxsys Rx - Rush LLC | Pharmacy | 14916 Hwy 16 W, Unit #1, Dekalb, MS 39328 | 2019-11-19 |
| 1518501592 | Southwest Pharmacy Inc | Pharmacy | 3000 Plaza Dr Ste B, Tylertown, MS 39667-9227 | 2019-11-01 |
| 1669015210 | Hometown Family Pharmacy, Inc. | Pharmacy | 930 Hall St Ste H, Wiggins, MS 39577-2113 | 2019-10-25 |
| 1225671001 | A & A Infusion & Specialty, LLC | Pharmacy | 124 E Jackson St, Belzoni, MS 39038-3642 | 2019-10-23 |
| Find all providers with the same taxonomy | ||||
| City | MOSS POINT |
| Zip Code | 39563 |
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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.