MISSISSIPPI CVS PHARMACY LLC (NPI# 1366735185) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366735185 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #03124 |
| Practice Address |
2507 Hardy St Hattiesburg MS 39401-5914 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6015442545 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2011-05-26 |
| Last Update Date | 2011-12-22 |
| Authorized Official Name | SUSAN COLBERT (DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 00251711 | 05 | |
| MS | MEDICAID DME | 02955091 | 01 |
| NCPDP | 2588347 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #03124 | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740682210 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1435 N. Frontage Rd, Vicksburg, MS 39180-5170 | 2014-09-16 |
| 1710314463 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 365 Cole Rd, Hattiesburg, MS 39402 | 2013-09-26 |
| 1770826158 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 801 Highway 80 E, Clinton, MS 39056-5252 | 2013-04-03 |
| 1942562533 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 12024 Lamey Bridge Rd, Diberville, MS 39540-8906 | 2012-06-11 |
| 1922366756 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 1912 Jackson Ave W, Oxford, MS 38655-4454 | 2012-04-30 |
| 1356618979 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 800 E Fifteenth St, Yazoo City, MS 39194-7625 | 2011-11-28 |
| 1598054082 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 750 City Ave S, Ripley, MS 38663-2520 | 2011-04-05 |
| 1730311689 | Mississippi Cvs Pharmacy LLC | Pharmacy | 3867 Promenade Pkwy, Diberville, MS 39540-5372 | 2009-08-11 |
| 1528229614 | Mississippi Cvs Pharmacy LLC | Pharmacy | 5150 Goodman Rd, Olive Branch, MS 38654-7903 | 2008-06-20 |
| 1174798417 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6040 Goodman Rd, Walls, MS 38680 | 2008-04-28 |
| Street Address |
2507 HARDY ST |
| City | HATTIESBURG |
| State | MS |
| Zip Code | 39401-5914 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275900581 | Mohammad Khan | Pharmacist | 2507 Hardy St, Hattiesburg, MS 39401-5914 | 2015-08-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598315863 | Lisa Thornton | Technician | 18 Timberline Dr., Hattiesburg, MS 39401 | 2019-09-18 |
| 1548813637 | Caroline Estes Barnes | Counselor | Barnes, 8 App Slade Road, Hattiesburg, MS 39401 | 2019-07-18 |
| 1396252441 | Selection Healthcare Services, LLC | In Home Supportive Care | 606 Adeline St Ste 1c, Hattiesburg, MS 39401 | 2018-01-10 |
| 1225545585 | Whitney Wilkinson | Nurse Practitioner | 301 South 28th Avenue, Hattiesburg, MS 39401 | 2018-01-08 |
| 1740795806 | Forrest General Hospital | Pharmacy | 1414 South 28th Avenue, Hattiesburg, MS 39401 | 2017-12-11 |
| 1275058455 | Casey Payne | Pharmacist | 6130 Us 49, Hattiesburg, MS 39401 | 2017-08-08 |
| 1225562705 | Sarah Marie Hudson | Family Medicine | 6051 Us Highway 49 S, Hattiesburg, MS 39401 | 2017-04-12 |
| 1043671704 | The Covington's Cove Assisted Living Center LLC | Assisted Living Facility | 192 Mary Magdalene Church Rd, Hattiesburg, MS 39401 | 2016-03-09 |
| 1780083626 | Dominique Reed Watson | Pharmacist | 602 Adeline St, Hattiesburg, MS 39401 | 2014-08-15 |
| 1558778936 | Willie Davis Jr. | Day Training, Developmentally Disabled Services | 701 Duke Ave., Hattiesbiurg, MS 39401 | 2014-07-17 |
| Find all providers in zip 39401 | ||||
| Taxonomy Code | 333600000X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located. |
| 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: added definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922557115 | Thrive Rx LLC | Pharmacy | 6440 U S Highway 98, Hattiesburg, MS 39402-8437 | 2016-09-28 |
| 1669512109 | Uni Care Rx LLC | Pharmacy | 124 Walnut Cir, Ste 1, Hattiesburg, MS 39401-3500 | 2007-02-07 |
| 1750421293 | Southwest Drugstore of Ms Inc | Pharmacy | 1601 Adeline St, Hattiesburg, MS 39401-6267 | 2007-02-07 |
| 1407861016 | Hattiesburg Clinic Pa | Pharmacy | Medical Blvd, Ste 2, Hattiesburg, MS 39401 | 2006-07-30 |
| 1578595518 | Freds Stores of Tennessee Inc | Pharmacy | 1000 Broadway Dr Ste 50, Hattiesburg, MS 39401-7572 | 2006-07-07 |
| 1275569907 | Rxs | Pharmacy | 2516 Old Highway 24, Hattiesburg, MS 39402-8311 | 2006-06-24 |
| 1013410737 | Pharmacy Plus, Inc. | Pharmacy | 115 S 40th Ave, Suite A, Hattiesburg, MS 39402-6600 | 2018-03-09 |
| 1336416973 | Downtown Pharmacy | Pharmacy | 511 W Laurel Ave, Hattiesburg, MS 39401-3504 | 2011-11-28 |
| 1861645657 | Region 12 Commission On Mental Health & Retardation Pine | Pharmacy | 103 S 19th Ave, Hattiesburg, MS 39401-6171 | 2008-10-24 |
| 1578603015 | Walnut Square Pharmacy LLC | Pharmacy | 124 Walnut Cir, Ste 3, Hattiesburg, MS 39401-3500 | 2007-02-07 |
| Find all providers in HATTIESBURG | ||||
| City | HATTIESBURG |
| Zip Code | 39401 |
Please comment or provide details below to improve the information on MISSISSIPPI CVS PHARMACY LLC.
| 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.