MISSISSIPPI CVS PHARMACY LLC (NPI# 1528229614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528229614 |
| Entity Type | Organization |
| Organization Name | MISSISSIPPI CVS PHARMACY LLC |
| Other Organization Name | CVS PHARMACY #17498 |
| Practice Address |
5150 Goodman Rd Olive Branch MS 38654-7903 |
| Mailing Address |
1 Cvs Dr Box 1075 Woonsocket RI 02895-6146 |
| Practice Telephone | 6628923032 |
| Practice Fax Number | 6628923042 |
| Mailing Telephone | 4017651500 |
| Enumeration Date | 2008-06-20 |
| Last Update Date | 2016-11-04 |
| Authorized Official Name | SUSAN COLBERT (SR. DIRECTOR, PAYER RELATIONS) |
| Authorized Official Telephone | 4017702751 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
07763/1.2 | MS | Suppliers |
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | Suppliers | ||
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2047545 | 01 |
| Other Name | Type Code |
|---|---|
| CVS Pharmacy #17498 | 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 |
| 1366735185 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 2507 Hardy St, Hattiesburg, MS 39401-5914 | 2011-05-26 |
| 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 |
| 1174798417 | Mississippi Cvs Pharmacy LLC | Durable Medical Equipment & Medical Supplies | 6040 Goodman Rd, Walls, MS 38680 | 2008-04-28 |
| Street Address |
5150 GOODMAN RD |
| City | OLIVE BRANCH |
| State | MS |
| Zip Code | 38654-7903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386038321 | Jason Max Ghio | Pharmacist | 5150 Goodman Rd, Olive Branch, MS 38654-7903 | 2015-03-27 |
| 1194019463 | Brandi Reed | Pharmacist | 5150 Goodman Rd, T-2442, Olive Branch, MS 38654-7903 | 2011-06-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093366213 | Latonya Shontae Binion | Home Health | 5915 Brice Cove North, Olive Branch, MS 38654 | 2019-09-28 |
| 1356828677 | Heath Bryan Coleman, Dds of Mississippi II, Pllc | Dentist | 688 Goodman Rd, Ste 123, Olive Branch, MS 38654 | 2018-07-20 |
| 1629565684 | Alexis Summerville Mcdavis | Pharmacist | 7950 Craft Goodman Frontage Rd, Olive Branch, MS 38654 | 2018-04-16 |
| 1194237206 | Exos Physical Therapy and Sports Medicine, LLC | Physical Therapist | 6542 Goodman Rd, Olive Branch, MS 38654 | 2017-10-30 |
| 1609386515 | Laken Hood Richardson | Physical Therapist | 9085 East Sandidge Cove, Suite 250, Olive Branch, MS 38654 | 2017-10-05 |
| 1275064255 | Heart of Hospice, LLC | Hospice Care, Community Based | 9849 Highway 178 Unit B, Olive Branch, MS 38654 | 2017-03-22 |
| 1023557865 | Michael Patrick Mccallum | Counselor | 9320 Railroad Ave., Olive Branch, MS 38654 | 2017-02-13 |
| 1891179768 | Desoto Children's Clinic - Olive Branch | Pediatrics | 7145 Goodman Road, Olive Branch, MS 38654 | 2015-07-10 |
| 1891185203 | Kristina Harper | Midwife | 9086 Pigeon Roost Rd Ste C, Olive Branch, MS 38654 | 2015-01-23 |
| 1275955098 | Global Medical | Durable Medical Equipment & Medical Supplies | 6229 Hwy 305 Ste L, Olivebranch, MS 38654 | 2014-01-14 |
| Find all providers in zip 38654 | ||||
| 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 |
|---|---|---|---|---|
| 1588015713 | Uhs of Parkwood Inc | Pharmacy | 8135 Goodman Rd Bldg D, Building D, Olive Branch, MS 38654-2103 | 2016-06-29 |
| 1467722868 | P and C Pharmacy Inc | Pharmacy | 9035 E Sandidge Rd Ste 101, Olive Branch, MS 38654-3563 | 2012-01-03 |
| 1629114285 | Klepzig Smith Inc | Pharmacy | 9065 Sandidge Center Cove, Suite A, Olive Branch, MS 38654 | 2007-01-30 |
| 1932131976 | Freds Stores of Tennessee Inc | Pharmacy | 7105 Cockrum St, Olive Branch, MS 38654-1629 | 2006-07-07 |
| 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 |
| Find all providers with the same taxonomy | ||||
| City | OLIVE BRANCH |
| Zip Code | 38654 |
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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.