NORTHLAUREL DISCOUNT DRUGS, INC. (NPI# 1649209305) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1649209305 |
Entity Type | Organization |
Organization Name | NORTHLAUREL DISCOUNT DRUGS, INC. |
Other Organization Name | QUINN PHARMACY |
Practice Address |
3160 Audubon Dr Laurel MS 39440-1926 |
Practice Telephone | 6014280688 |
Practice Fax Number | 6014280689 |
Mailing Telephone | 6014280688 |
Mailing Fax Number | 6014280689 |
Enumeration Date | 2006-07-02 |
Last Update Date | 2016-08-16 |
Authorized Official Name | MR. JAMES L. HICKS, III (PHARMACY MANAGER) |
Authorized Official Telephone | 6014280688 |
Authorized Official Credential | RPH |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 3336C0003X |
Pharmacy Specialization: Community/Retail Pharmacy |
01101/01.1 | MS | Suppliers |
N | 3336C0004X |
Pharmacy Specialization: Compounding Pharmacy |
01101/01 | MS | Suppliers |
N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
1101/01 | MS | Suppliers |
Y | 332BP3500X |
Durable Medical Equipment & Medical Supplies Specialization: Parenteral & Enteral Nutrition |
01101/01.1 | MS | Suppliers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
MS | 00030428 | 05 |
Other Name | Type Code |
---|---|
Quinn Pharmacy | Doing Business As Name - Organization |
Street Address |
3160 AUDUBON DR |
City | LAUREL |
State | MS |
Zip Code | 39440-1926 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1780625897 | James L. Hicks, IIi | Pharmacist | 3160 Audubon Dr, Laurel, MS 39440-1926 | 2006-06-09 |
1619050150 | Jack Larry Sanders | Pharmacist | 3160 Audubon Dr, Laurel, MS 39440 | 2006-10-20 |
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Taxonomy Code | 332BP3500X |
Grouping | Suppliers |
Classification | Durable Medical Equipment & Medical Supplies |
Specialization | Parenteral & Enteral Nutrition |
Definition to come... |
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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.