MEMORIAL HOSPITAL OF GULFPORT (NPI# 1790818532) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790818532 |
| Entity Type | Organization |
| Organization Name | MEMORIAL HOSPITAL OF GULFPORT |
| Other Organization Name | MHG EMPLOYEE PHARMACY |
| Practice Address |
4500 13th St Gulfport MS 39501-2515 |
| Mailing Address |
Po Box 1810 4500 13th St Gulfport MS 39502-1810 |
| Practice Telephone | 2288653525 |
| Practice Fax Number | 2288653618 |
| Mailing Telephone | 2288653525 |
| Mailing Fax Number | 2288653618 |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | ALBERT JOSEPH KWITZKY (EMPLOYEE PHARMACY COORDINATOR) |
| Authorized Official Telephone | 2288653045 |
| Authorized Official Credential | PHARMACIST |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 333600000X | Pharmacy | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MS | 20027 | 05 | |
| MS | STATE LICENSE | 0155003.1 | 01 |
| MS | DEA REGISTRATION | AM2473344 | 01 |
| Other Name | Type Code |
|---|---|
| MHG EMPLOYEE PHARMACY | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669619912 | Memorial Hospital of Gulfport | Urology | 1340 Broad Ave, Ste 210, Gulfport, MS 39501-2404 | 2009-01-08 |
| Street Address |
4500 13TH ST |
| City | GULFPORT |
| State | MS |
| Zip Code | 39501-2515 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790777142 | Jack Q Causey II | Specialist | 4500 13th St, Gulfport, MS 39501-2515 | 2005-08-20 |
| 1255940110 | Brittany Threatt | Specialist/Technologist, Other | 4500 13th St, Gulfport, MS 39501-2515 | 2020-07-27 |
| 1881217792 | Dawn M Waters | Technician, Other | 4500 13th St, Gulfport, MS 39501-2569 | 2020-05-26 |
| 1356963953 | Jamie Rea Morris | Family Medicine | 4500 13th St, Gulfport, MS 39501-2515 | 2020-05-18 |
| 1497374490 | Alicia Lee Ellsberry | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-10 |
| 1578192035 | Lauren Martino | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2020-04-06 |
| 1942840368 | Addie Holleman Holcomb | Registered Nurse | 4500 13th St, Gulfport, MS 39501-2515 | 2020-01-14 |
| 1477190114 | Shannon Vallee Canzoneri | Pharmacist | 4500 13th St, Gulfport, MS 39501-2515 | 2019-12-02 |
| 1629614003 | Kanieshia M Mitchell | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2569 | 2019-11-21 |
| 1346882339 | Molly H Weir | Nurse Practitioner | 4500 13th St, Gulfport, MS 39501-2515 | 2019-10-11 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301632 | Daniel Edward Bloom | Physician Assistant | Naval Branch Health Clinic Gulfport, 5502 Marvin Shields Blvd, Gulfport, MS 39501 | 2019-11-25 |
| 1730721374 | Affinity Healthcare LLC | Non-emergency Medical Transport (VAN) | 1822 15th St, Suite 8, Gulfport, MS 39501 | 2019-10-15 |
| 1093361156 | Gulf Coast Companion Care, LLC | Home Health | 1314 Pass Road, Ste B, Gulfport, MS 39501 | 2019-08-14 |
| 1609420991 | Greg Meekin Ent | Otolaryngology | 1201 31st Avenue, Gulfport, MS 39501 | 2019-07-25 |
| 1225681216 | Murphy Chiropractic Gulfport, LLC | Clinic/Center | 2700 25th Ave., Gulfport, MS 39501 | 2019-07-19 |
| 1477022838 | Patriot Healthcare of Mississippi, LLC | Family Medicine | 1110 Broad Street, Suite 300, Gulfport, MS 39501 | 2018-11-15 |
| 1477003028 | Mindful Matters | Nurse Practitioner | 1613 23rd Avenue, Gulfport, MS 39501 | 2016-10-06 |
| 1902294093 | Tangular Barnes | Nurse Practitioner | Gulf Coast Mental Health Center, 1600 Broad Ave, Gulfport, MS 39501 | 2014-12-25 |
| 1487065355 | Huong Nguyen | Pharmacist | 2433 25th Avenue, Gulfport, MS 39501 | 2014-05-14 |
| 1770907412 | Matthew Coleman | Military Health Care Provider | Nbhc Naval Construction Battalion Center Gulfport, 5501 Marvin Shields Blvd, Gulfport, MS 39501 | 2014-02-18 |
| Find all providers in zip 39501 | ||||
| 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 |
|---|---|---|---|---|
| 1386709715 | Beach Pharmacy Inc | Pharmacy | 1110 Cowan Rd, Gulfport, MS 39507-3441 | 2006-12-26 |
| 1578622577 | French Drug Company Inc | Pharmacy | 400 E Pass Rd, Gulfport, MS 39507-3236 | 2006-12-06 |
| 1982629549 | The Great Atlantic and Pacific Tea Company Inc | Pharmacy | 1345 Pass Rd, Gulfport, MS 39507 | 2006-07-13 |
| 1043244361 | Triplett Day Drug Co Inc | Pharmacy | 2429 14th St, Gulfport, MS 39501-2020 | 2006-07-11 |
| 1164453288 | K Mart Corp | Pharmacy | 1355 E Pass Rd, Gulfport, MS 39507-3406 | 2006-07-06 |
| 1326084831 | Jacksons Discount Pharmacy Inc | Pharmacy | 11340 Three Rivers Rd, Ste A, Gulfport, MS 39503-3660 | 2006-06-22 |
| 1073063327 | Memorial Hospital At Gulfport | Pharmacy | 4500 13th St, Gulfport, MS 39501-2515 | 2016-10-11 |
| 1790798999 | Sartin's Vital Care, Inc. | Pharmacy | 4300 15th St, Suite A, Gulfport, MS 39501-2524 | 2006-08-15 |
| 1518970714 | Sartin's Vital Care Inc | Pharmacy | 4300 15th St, Suite A, Gulfport, MS 39501-2524 | 2006-08-15 |
| 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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| 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.