MISSISSIPPI CVS PHARMACY, L.L.C. (NPI# 1508179888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508179888 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY, L.L.C. |
| Other Organization Name | CVS PHARMACY #04519 |
| Practice Address |
205 Highway 16 West Carthage MS 39051 |
| Mailing Address |
1 Cvs Dr Box 1075-pharmacy Enrollments Woonsocket RI 02895-6146 |
| Practice Telephone | 6012679195 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2010-07-15 |
| Last Update Date | 2012-03-01 |
| 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 | MEDICAID DME | 00950021 | 01 |
| MS | 05828571 | 05 | |
| NCPDP | 2588070 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #04519 | Doing Business As Name - Organization |
| 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 |
| 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 |
| 1417183922 | Mississippi Cvs Pharmacy, L.L.C. | Durable Medical Equipment & Medical Supplies | 2945 Goodman Road East, Southaven, MS 38672 | 2009-06-10 |
| 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 |
| Street Address |
205 HIGHWAY 16 WEST |
| City | CARTHAGE |
| State | MS |
| Zip Code | 39051 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598275828 | Roots Healthcare and Homes, LLC | Meals | 292 Pickens Circle, Carthage, MS 39051 | 2017-09-30 |
| 1427575505 | Trend Health and Rehab of Carthage | Skilled Nursing Facility | 1101 E. Franklin Street, Carthage, MS 39051 | 2017-08-29 |
| 1750738415 | Telehealthone LLC | Nurse Practitioner | 300 South Pearl Street, Carthage, MS 39051 | 2016-05-23 |
| 1316297575 | Silver Lining Adult Daycare, LLC | Respite Care | 531 Highway 35 North, Carthage, MS 39051 | 2012-09-14 |
| 1376725754 | Amye L Shamburger | Dentist | 101 S. Pearl Street, Carthage, MS 39051 | 2007-11-28 |
| 1770786188 | Carthage Eye Clinic Pa | Optometrist | 201 Hwy 16 East, Carthage, MS 39051 | 2007-06-06 |
| 1265553762 | David C Henderson | Dentist | 113 North Pearl St, Carthage, MS 39051 | 2007-04-02 |
| 1780722280 | Linda N Roland | Nurse Practitioner | 204 Chipley St., Carthage, MS 39051 | 2007-02-05 |
| 1205914298 | William M Myers II | Dentist | 12646 Hwy 488, Carthage, MS 39051 | 2006-11-01 |
| 1548353063 | Beverly Enterprises - Mississippi Inc | Skilled Nursing Facility | 1101 E Franklin St, Carthage, MS 39051 | 2006-10-02 |
| Find all providers in zip 39051 | ||||
| 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 |
|---|---|---|---|---|
| 1487098448 | Nw Carthage LLC | Pharmacy | 1601 Missouri Ave, Carthage, MO 64836-3060 | 2013-04-22 |
| 1700036068 | Ken Turner Pharmacy Inc | Pharmacy | 109 E Panola St, Carthage, TX 75633-2601 | 2008-09-23 |
| 1801946991 | Southern Pines Prescription Shop, Inc | Pharmacy | 1016 Monroe St, Carthage, NC 28327 | 2007-01-11 |
| 1215011341 | Hacketts Discount Drugs Inc | Pharmacy | 70 Dixon Springs Hwy, Carthage, TN 37030-1063 | 2006-10-25 |
| 1285728931 | Carthage Pharmacy Services Inc | Pharmacy | 2017 S Garrison Ave, Carthage, MO 64836-3613 | 2006-10-03 |
| 1760581086 | Brookshire Brothers Inc | Pharmacy | 412 W Panola St, Carthage, TX 75633-2537 | 2006-09-22 |
| 1851401541 | Kerr Drug Inc | Pharmacy | 1006 Monroe St, Carthage, NC 28327-7387 | 2006-08-30 |
| 1649387820 | Kph Healthcare Services, Inc. | Pharmacy | 401 State St, Carthage, NY 13619-1413 | 2006-08-24 |
| 1679591333 | Wal-mart Stores Texas LLC | Pharmacy | 4609 Nw Loop # 436, Carthage, TX 75633-2205 | 2006-07-18 |
| 1821523861 | Praters Pharmacy LLC | Pharmacy | 3069 S Grand Ave, Carthage, MO 64836 | 2017-04-27 |
| Find all providers in CARTHAGE | ||||
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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.