EAST MISSISSIPPI STATE HOSPITAL (NPI# 1649323254) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1649323254 |
| Entity Type | Organization |
| Organization Name | EAST MISSISSIPPI STATE HOSPITAL |
| Practice Address |
4555 Highland Park Dr Meridian MS 39307 |
| Mailing Address |
4555 Highland Park Dr Meridian MS 39307-5429 |
| Practice Telephone | 6015817818 |
| Practice Fax Number | 6015817822 |
| Mailing Telephone | 6014812521 |
| Mailing Fax Number | 6014811293 |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-05-12 |
| Authorized Official Name | DONALD R MCKAY (PHARMACIST) |
| Authorized Official Telephone | 6015817818 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 283Q00000X | Psychiatric Hospital | MS | Hospitals | |
| N | 333600000X | Pharmacy | 01108031 | MS | Suppliers |
| N | 3336L0003X |
Pharmacy Specialization: Long Term Care Pharmacy |
01108031 | MS | Suppliers |
| Y | 3336I0012X |
Pharmacy Specialization: Institutional Pharmacy |
01108031 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NCPDP | 2517689 | 01 | |
| MS | 00330069 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407269756 | East Mississippi State Hospital | Psychiatric Unit | 1401 College Dr, Meridian, MS 39307-5345 | 2014-06-04 |
| 1972689313 | East Mississippi State Hospital | Nursing Facility/Intermediate Care Facility | 4555 Highland Park Drive, Meridian, MS 39307-2903 | 2006-10-27 |
| 1346522653 | East Mississippi State Hospital | Clinic/Center | 1818 College Drive, Meridian, MS 39307-5429 | 2011-09-13 |
| 1225342173 | East Mississippi State Hospital | Psychiatric Hospital | 4555 Highland Park Drive, Meridian, MS 39307 | 2010-08-03 |
| 1629394853 | East Mississippi State Hospital | Nursing Facility/Intermediate Care Facility | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-04-13 |
| 1841490612 | East Mississippi State Hospital | Dentist | 1818 College Drive, Reimbursement Dept., Meridian, MS 39307-5429 | 2007-07-20 |
| Street Address |
4555 HIGHLAND PARK DR |
| City | MERIDIAN |
| State | MS |
| Zip Code | 39307 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740349257 | Hermogenes V Thomas | General Practice | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2006-12-08 |
| 1609232123 | Vickie L Warren | Nurse Practitioner | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2016-01-13 |
| 1326458837 | Marcy Tingle | Pharmacist | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2014-05-06 |
| 1447660956 | Donald Mckay | Pharmacist | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2014-05-06 |
| 1356689640 | Angela Marshon Mars | Counselor | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2013-01-22 |
| 1891059184 | Curtis Lee Jones | Social Worker | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2012-07-02 |
| 1558679902 | Physician Group | Clinic/Center | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-09-20 |
| 1649587460 | Stella Elizabeth Gervin-ward | Social Worker | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-09-01 |
| 1629394853 | East Mississippi State Hospital | Nursing Facility/Intermediate Care Facility | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-04-13 |
| 1093038234 | Magnolia Clinic | Clinic/Center | 4555 Highland Park Dr, Meridian, MS 39307-5429 | 2010-03-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841824232 | Erica Sheree Smith | Registered Nurse | 1818 College Dr, Meridian, MS 39307 | 2020-02-25 |
| 1518481480 | Derrick Pringle | Social Worker | 110 48th Ave, Meridian, MS 39307 | 2017-08-01 |
| 1821519547 | Leslie Rutkowski | Student in an Organized Health Care Education/Training Program | 2514 67th Avenue Loop Suite 112, Meridian, MS 39307 | 2017-07-03 |
| 1811254931 | Meridian Community College | Dentist | 910 Highway 19 North, Meridian, MS 39307 | 2012-04-13 |
| 1548533672 | Carvan Lorraine Carter | Counselor | 1807 39th Pl, Meridian, MS 39307 | 2012-02-21 |
| 1699921148 | Sara B Smith | Counselor | 1415 College Drive, Meridian, MS 39307 | 2008-08-15 |
| 1285856112 | Jan Parr Boggs | Psychologist | 1508 37th Avenue, Meridian, MS 39307 | 2007-05-02 |
| 1720694029 | Michelle Gomez Dickerson | Registered Nurse | 1818 College Drive, Meridian, MS 39307 | 2020-09-22 |
| 1770116030 | Briana Shanee Brunson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-02-14 |
| 1619507407 | Brenda A Thompson | Nurse Practitioner | 1818 College Drive, Meridian, MS 39307 | 2020-01-21 |
| Find all providers in zip 39307 | ||||
| Taxonomy Code | 3336I0012X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Institutional Pharmacy |
| A pharmacy in a hospital (inpatient) or institution used by pharmacists for the compounding and delivery of medicinal preparations to be administered to the patient by nursing or other authorized personnel. Institutional Pharmacies also counsel patients and caregivers; administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. |
| 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: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215228911 | St Luke's Meridian Inpt Pharmacy | Pharmacy | 520 S Eagle Rd, Attn: Basement, Meridian, ID 83642-6351 | 2011-04-28 |
| 1487787347 | Alliance Health Center Pharmacy | Pharmacy | 5000 Highway 39 N, Meridian, MS 39301-1021 | 2007-03-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104998269 | Pharmakan, Inc | Pharmacy | 1042a River Oaks Dr, Flowood, MS 39232-9594 | 2006-11-14 |
| 1558372193 | Diamond Grove Ctr Pharmacy | Pharmacy | 2311 Highway 15 S, Louisville, MS 39339-7071 | 2006-08-10 |
| 1740202571 | Boswell Regional Center | Pharmacy | 1049 Hwy 149, Magee, MS 39111 | 2006-07-24 |
| 1962999789 | State Veterans Affairs Board | Pharmacy | 4607 Lindbergh Dr, Jackson, MS 39209-3855 | 2018-04-17 |
| 1023549060 | Brentwood Acquisition Pharmacy | Pharmacy | 3531 Lakeland Dr, Flowood, MS 39232-8049 | 2017-03-22 |
| 1285177394 | Formulaone Pharmaceuticals, LLC | Pharmacy | 127 Pratt Dr, Corinth, MS 38834-6026 | 2016-11-21 |
| 1578989430 | King's Daughters Hospital Pharmacy | Pharmacy | 823 Grand Ave, Yazoo City, MS 39194-3233 | 2014-03-14 |
| 1841623808 | George County Pharmacy | Pharmacy | 92 Ratliff St, Lucedale, MS 39452-6537 | 2013-08-14 |
| 1619000593 | Diamond Grove Center | Pharmacy | 2311 Highway 15 S, Louisville, MS 39339-7071 | 2007-03-13 |
| 1194850917 | North Mississippi State Hospital Pharmacy | Pharmacy | 1937 Briar Ridge Rd, Tupelo, MS 38804-5963 | 2007-02-22 |
| Find all providers with the same taxonomy | ||||
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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.