SOUTHERN PHARMACY CLINICAL MANAGEMENT (NPI# 1295268985) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295268985 |
| Entity Type | Organization |
| Organization Name | SOUTHERN PHARMACY CLINICAL MANAGEMENT |
| Other Organization Name | SOUTHERN PHARMACY RX |
| Practice Address |
3224 Dijon Ave Ocean Springs MS 39564-8520 |
| Practice Telephone | 2283630500 |
| Practice Fax Number | 8006513566 |
| Mailing Telephone | 2283630500 |
| Mailing Fax Number | 8006513566 |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2017-04-10 |
| Authorized Official Name | TAMMY NERON (PARTNER CEO) |
| Authorized Official Telephone | 2283630500 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | STATE MS BUSINESS ID | 1112650 | 01 |
| Other Name | Type Code |
|---|---|
| Southern Pharmacy Rx | Doing Business As Name - Organization |
| Street Address |
3224 DIJON AVE |
| City | OCEAN SPRINGS |
| State | MS |
| Zip Code | 39564-8520 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720364722 | Advanced Bracing Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3224 Dijon Ave, Ocean Springs, MS 39564-8520 | 2011-10-23 |
| 1962811158 | Advanced Medical and Bracing Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3224 Dijon Ave, Ocean Springs, MS 39564-8520 | 2014-08-12 |
| 1609285246 | Joseph Hunter Steiner | Specialist | 3224 Dijon Ave, Ocean Springs, MS 39564-8520 | 2014-08-07 |
| 1013263813 | Advanced Bracing Solutions, LLC | Durable Medical Equipment & Medical Supplies | 3224 Dijon Ave, Ocean Springs, MS 39564-8520 | 2012-07-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750996401 | Shelby Bourgeois | Speech-Language Pathologist | 108 Heron Park Pl, Ocean Springs, MS 39564 | 2020-09-10 |
| 1467010520 | Rachel Stephenie Knox | Student in an Organized Health Care Education/Training Program | 81mdss/gme 301 Fisher St., Rm 1g123, Keesler Afb, MS 39564 | 2019-06-04 |
| 1457839292 | Polly Anne Lampon | Registered Nurse | 2301 Rue Beaux Chenes, Ocean Springs, MS 39564 | 2018-08-03 |
| 1578062725 | Gulf Coast Sleep Medicine LLC | Clinic/Center | 2112 Bienville Blvd., Suite P, Ocean Springs, MS 39564 | 2018-02-02 |
| 1598212623 | Edward Victor Brown Jr. | Dentist | 15465 Oak Lane, Gulfport, MS 39564 | 2016-09-07 |
| 1386016749 | L. Randy Buntyn, D.m.d., Pllc | Dentist | 1203 Government St., Ocean Springs, MS 39564 | 2015-10-26 |
| 1467835629 | Msmobileyes Inc. | Optometrist | 2510 Bileville Blvd, Ocean Springs, MS 39564 | 2015-07-07 |
| 1659760999 | Clark Jamison Levi | Pharmacist | 1019 Government Street Suite F & D, Ocean Springs, MS 39564 | 2015-01-09 |
| 1932545480 | Therese Anne Hanna | Nurse Practitioner | 6900 Washington Avenue, Ocean Springs, MS 39564 | 2013-05-10 |
| 1346589421 | Jennah Claine Ladner | Nurse Practitioner | 1137 Ocean Springs Road, Ocean Springs, MS 39564 | 2013-02-08 |
| Find all providers in zip 39564 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1417090093 | University Pavilion Pharmacy | Pharmacy | 1410 E Woodrow Wilson Dr, Jackson, MS 39216 | 2007-02-14 |
| 1518040500 | Region Iv Mh Mr Commission Phcy | Pharmacy | 2301b E Chambers Dr, Booneville, MS 38829 | 2006-10-23 |
| 1912452921 | Sports Medicine Pharmacy LLC | Pharmacy | 1325 E Fortification St, Jackson, MS 39202-2442 | 2016-08-19 |
| 1689039711 | River Region Health System | Pharmacy | 2100 Highway 61 N, Pharmacy, Vicksburg, MS 39183-8211 | 2015-12-16 |
| 1891171351 | Prime Urgent Medical Clinic | Pharmacy | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2015-08-07 |
| 1578956264 | Alliance Healthcare System | Pharmacy | 1938 Crescent Meadows Dr, Holly Springs, MS 38635-7419 | 2015-03-05 |
| 1871927517 | Southeast Mississippi Rural Health Initiative, Inc. | Pharmacy | 62 Old Airport Rd, Hattiesburg, MS 39401-8382 | 2013-08-29 |
| 1689915423 | Region Iv Desoto County Pharmacy | Pharmacy | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2013-03-04 |
| 1740417922 | Coastal Family Health Center, Inc. | Pharmacy | 1025 Division St, Ste A, Biloxi, MS 39530-2906 | 2009-06-16 |
| 1508072273 | Foot Solutions LLC | Pharmacy | 120 Market St, Woodland, MS 39776-9104 | 2007-05-16 |
| Find all providers with the same taxonomy | ||||
| City | OCEAN SPRINGS |
| Zip Code | 39564 |
Please comment or provide details below to improve the information on SOUTHERN PHARMACY CLINICAL MANAGEMENT.
| 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.