MISSISSIPPI CVS PHARMACY, L.L.C.


Address: 2945 Goodman Road East, Southaven, MS 38672
Phone: 4017651500

MISSISSIPPI CVS PHARMACY, L.L.C. (NPI# 1417183922) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1417183922
Entity Type Organization
Organization Name MISSISSIPPI CVS PHARMACY, L.L.C.
Other Organization Name CVS PHARMACY #08491
Practice Address 2945 Goodman Road East
Southaven
MS 38672
Mailing Address 1 Cvs Dr
Box 1075 -pharmacy Enrollments
Woonsocket
RI 02895-6146
Practice Telephone 4017651500
Mailing Telephone 4017651500
Enumeration Date 2009-06-10
Last Update Date 2014-07-11
Authorized Official Name SUSAN COLBERT (DIRECTOR, PAYER RELATIONS)
Authorized Official Telephone 4017702751
Is Organization Subpart N

Taxonomy

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

Other Provider Identifier

State Issuer Identifier Type Code
MS 04829726 05
NCPDP 2587674 01

Other Provider/Organization Names

Other Name Type Code
CVS Pharmacy #08491 Doing Business As Name - Organization

Other Provider IDs and Locations

NPI Name Taxonomy Address Enumeration
1255647541 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 301 American Ave, Booneville, MS 38829-1001 2010-08-24
1508179888 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 205 Highway 16 West, Carthage, MS 39051 2010-07-15
1063734291 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 135 Highway 15 N, Pontotoc, MS 38863-1914 2010-02-15
1093046500 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 5025 Highway 305 N, Olive Branch, MS 38654-3602 2010-01-22
1255561916 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 2955 Church Rd E, Southaven, MS 38671-9767 2009-07-16
1720217524 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 7363 Goodman Rd, Olive Branch, MS 38654-1906 2009-07-14
1437393311 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 55 Goodman Rd W, Southaven, MS 38671-9447 2009-04-23
1144468802 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 305 Meadowbrook Rd., Jackson, MS 39206 2009-02-03
1861654733 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 1209 Sunset Dr, Grenada, MS 38901-4063 2008-07-01
1225213408 Mississippi Cvs Pharmacy, L.L.C. Durable Medical Equipment & Medical Supplies 25820 W Main St, West Point, MS 39773-2763 2008-01-07

Office Location

Street Address 2945 GOODMAN ROAD EAST
City SOUTHAVEN
State MS
Zip Code 38672

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1871100826 Sarah Kathryn Pratt Physical Therapist 5271 Getwell Road, Suite A, Southaven, MS 38672 2020-09-24
1356713606 Deadra Dennis Behavioral Analyst 2816 Calico Rock Cv, Southaven, MS 38672 2015-10-27
1568727352 Patricia Leanne Lewis Family Medicine 5908 Getwell Rd, Southaven, MS 38672 2012-07-09
1568609998 Susan Orsland Physical Therapist 4355 Genevieve Drive, Southaven, MS 38672 2009-01-07
1659516524 Stacy L Sanders Audiologist 5740 Getwell Rd. Building 3 Unit B, Southaven, MS 38672 2008-12-08
1295927226 Tracey F Petrides Family Medicine 5779 Getwell Road, Building D, Suite 3, Southaven, MS 38672 2007-08-14
1538288741 Bruce A Denney Dentist 7125 Getwell Road, Suite 102, Southaven, MS 38672 2007-03-28
1154480150 Kimberly Marie Metcalf Social Worker 7165-g Getwell Rd., Southaven, MS 38672 2006-12-06
1346318441 Deborah Verucchi Nurse Practitioner 5740 Getwell Rd Ste B, Southaven, MS 38672 2006-11-30
1063520294 Michael Newton Phillips Physical Therapist 3451 Goodman Rd E Ste 108, Southaven, MS 38672 2006-08-28
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Taxonomy Information

Taxonomy Code 333600000X
Grouping Suppliers
Classification Pharmacy

Taxonomy Definition

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]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1831115781 Southern Home Care Pharmacy 8865 First Industrial Dr, Southaven, MS 38671-1919 2006-07-14
1164454104 Freds Stores of Tennessee Inc Pharmacy 8912 Office Park Plaza Dr, Southaven, MS 38671 2006-07-07
1659746584 Proxsys Rx - Rush LLC Pharmacy 7601 Southcrest Pkwy, Southaven, MS 38671-4739 2015-12-03
1619396892 Complete Diabetes Pharmacy Care Inc Pharmacy 7165 Swinnea Rd, Bldg B-2, Southaven, MS 38671-6360 2014-04-15
1275697435 Lincare Pharmacy Services Inc. Pharmacy 1235 Main Street, Southaven, MS 38671-1429 2006-12-21

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1457973067 Thomas Street Compounding Pharmacy Pharmacy 115 N Thomas St Ste G, Tupelo, MS 38801-3082 2020-05-18
1013558824 Downhome Pharmacy, Inc. Pharmacy 606 W. Broad St, Monticello, MS 39654 2019-10-02
1356997985 Sonshine Pharmacy, LLC Pharmacy 2745 Highway 371 N, Mantachie, MS 38855 2019-08-09
1699331868 Fulton Specialty Pharmacy, LLC Pharmacy 1509 S Adams St Ste D, Fulton, MS 38843-6621 2019-05-14
1063971539 National Pharmacy of Mississippi, LLC Pharmacy 371b Highland Colony Pkwy, Ridgeland, MS 39157-6035 2019-03-14
1811468952 Davidson Pharmacy, LLC Pharmacy 203a N 2nd St, Booneville, MS 38829-2701 2018-12-16
1346710720 Tupelo Specialty Pharmacy, LLC Pharmacy 1056 Cliff Gookin Blvd Ste C, Tupelo, MS 38801-6458 2018-11-28
1205302254 A & A Infusion & Specialty, LLC Pharmacy 423 Mcallister St, Greenville, MS 38701-4704 2018-10-17
1306325402 Family Drug Mart of Poplarville,llc Pharmacy 100 Highway 11 N, Poplarville, MS 39470-2217 2018-08-09
1851883789 Amory Discount Pharmacy, LLC Pharmacy 60379 Cotton Gin Port Rd Ste B, Amory, MS 38821-7204 2018-06-06
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Competitor

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City SOUTHAVEN
Zip Code 38672

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Dataset Information

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.

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