MIDSOUTH MEDICAL SPECIALTIES, LLC (NPI# 1255677001) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255677001 |
| Entity Type | Organization |
| Organization Name | MIDSOUTH MEDICAL SPECIALTIES, LLC |
| Other Organization Name | SUPER DRUGS #2 |
| Practice Address |
2260 Highway 515 South Hernando MS 38632 |
| Practice Telephone | 6624499075 |
| Practice Fax Number | 6624493414 |
| Mailing Telephone | 6624499075 |
| Mailing Fax Number | 6624493414 |
| Enumeration Date | 2012-12-26 |
| Last Update Date | 2012-12-26 |
| Authorized Official Name | MR. EDDIE O'BANNON (OWNER) |
| Authorized Official Telephone | 6624499075 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
11889 | MS | Suppliers |
| Other Name | Type Code |
|---|---|
| Super Drugs #2 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558894790 | Midsouth Medical Specialties, LLC | Pharmacy | 105 Sawtooth Oak St, Hot Springs, AR 71901-7160 | 2017-04-05 |
| 1215349667 | Midsouth Medical Specialties, LLC | Pharmacy | 5500 Central Avenue, Hot Springs, AR 71913 | 2014-05-20 |
| 1992139711 | Midsouth Medical Specialties, LLC | Pharmacy | 185 W Center St, Hernando, MS 38632-2268 | 2013-08-28 |
| 1215460688 | Midsouth Medical Specialties, LLC | Pharmacy | 1534 Malvern Ave, Hot Springs, AR 71901-6508 | 2017-04-04 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| New York State Corporations | MIDSOUTH MEDICAL SPECIALTIES, LLC | 200 Sterlin Lane, Hernando, Ms 38632 |
| Street Address |
2260 HIGHWAY 515 SOUTH |
| City | HERNANDO |
| State | MS |
| Zip Code | 38632 |
| 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 |
| 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 |
| 1629252093 | Debra Shelton | Counselor | 190 W South St, Hernando, MS 38632 | 2007-12-20 |
| Find all providers in zip 38632 | ||||
| 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 |
|---|---|---|---|---|
| 1265992291 | Getwell Pharmacy of Tennessee, Inc. | Pharmacy | 210 E Commerce St Ste 4, Hernando, MS 38632-2308 | 2019-03-25 |
| 1760640585 | Walgreen Co | Pharmacy | 950 E Commerce St, Hernando, MS 38632-2433 | 2008-05-29 |
| 1316472384 | V3 Healthcare Corporation | Pharmacy | 2260 Highway 51 S, Hernando, MS 38632-1737 | 2017-04-26 |
| 1891181798 | Dr. Michael Lyons PC | Pharmacy | 1558 Monteith Ave, Hernando, MS 38632-7685 | 2015-04-08 |
| 1912049073 | Funderburk's Pharmacy, Inc. | Pharmacy | 134 W Commerce St, Hernando, MS 38632-2240 | 2007-02-13 |
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|---|---|---|---|---|
| 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 | ||||
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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.