HORN LAKE FAMILY PRACTICE (NPI# 1356718233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1356718233 |
| Entity Type | Organization |
| Organization Name | HORN LAKE FAMILY PRACTICE |
| Other Organization Name | HORN LAKE FAMILY PRACTICE |
| Practice Address |
3102 Goodman Rd W Horn Lake MS 38637-1172 |
| Mailing Address |
1019 Government St Suite F Ocean Springs MS 39564-3860 |
| Practice Telephone | 6623426677 |
| Practice Fax Number | 6623420203 |
| Mailing Telephone | 2284473823 |
| Mailing Fax Number | 2284473812 |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2016-02-18 |
| Authorized Official Name | SHEETAL SHARMA (MEMBER) |
| Authorized Official Telephone | 6623426677 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
Suppliers | ||
| Y | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
14467 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2153358 | 01 |
| Other Name | Type Code |
|---|---|
| Horn Lake Family Practice | Doing Business As Name - Organization |
| Street Address |
3102 GOODMAN RD W |
| City | HORN LAKE |
| State | MS |
| Zip Code | 38637-1172 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093715641 | Achin Sharma | Family Medicine | 3102 Goodman Rd W, Horn Lake, MS 38637-1172 | 2005-07-26 |
| 1326527300 | Lauren Michelle Person | Nurse Practitioner | 3102 Goodman Rd W, Horn Lake, MS 38637-1172 | 2018-08-09 |
| 1851780597 | Ashley Marissa Craddock | Nurse Practitioner | 3102 Goodman Rd W, Horn Lake, MS 38637-1172 | 2015-01-19 |
| 1619377199 | Tim Davis | Nurse Practitioner | 3102 Goodman Rd W, Horn Lake, MS 38637-1172 | 2014-09-03 |
| 1508968421 | Horn Lake Family Practice Inc | Family Medicine | 3102 Goodman Rd W, Horn Lake, MS 38637-1172 | 2006-09-01 |
| 1750499067 | Melissa A Breitling | Emergency Medicine | 3102 Goodman Rd W, Horn Lake, MS 38637-1172 | 2006-08-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184098733 | Wal-mart Stores East, Lp | Technician/Technologist | 4150 Goodman Road West, Horn Lake, MS 38637 | 2015-11-19 |
| 1609116581 | Horn Lake Eyecare Pllc | Optometrist | 2085 Goodman Rd, Horn Lake, MS 38637 | 2013-02-28 |
| 1487806121 | Midsouth Medical Specialties LLC | Pharmacy | 1433 Goodman Rd W, Horn Lake, MS 38637 | 2008-10-14 |
| 1356417992 | William E Middleton Jr Dds Pa | Dentist | 3011 Goodman Road W, Horn Lake, MS 38637 | 2006-11-27 |
| 1104297753 | Wal-mart Stores East Lp | Durable Medical Equipment & Medical Supplies | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2015-10-08 |
| 1134617178 | Connie Irene Worley | Pharmacist | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2018-04-25 |
| 1598252710 | Justin Mathis | Pharmacist | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2018-04-13 |
| 1730686932 | Bradley Thomas Loeffel | Pharmacist | 4150 Goodman Rd, Horn Lake, MS 38637-0300 | 2018-04-12 |
| 1437759388 | Sarah Walls | Private Vehicle | 3765 Hilltop Dr, Horn Lake, MS 38637-1030 | 2020-10-29 |
| 1497901417 | William E. Middleton Jr. | Dentist | 3011 Goodman Rd W, Horn Lake, MS 38637-1103 | 2008-08-10 |
| Find all providers in zip 38637 | ||||
| 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 |
|---|---|---|---|---|
| 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.