PRIME URGENT MEDICAL CLINIC (NPI# 1891171351) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1891171351 |
| Entity Type | Organization |
| Organization Name | PRIME URGENT MEDICAL CLINIC |
| Other Organization Name | PRIME URGENT MEDICAL CLINIC |
| Practice Address |
176 Goodman Rd W Southaven MS 38671-9405 |
| Mailing Address |
1019 Government St Suite F Ocean Springs MS 39564-3860 |
| Practice Telephone | 6625106981 |
| Practice Fax Number | 6625106987 |
| Mailing Telephone | 2884473823 |
| Mailing Fax Number | 2284473812 |
| Enumeration Date | 2015-08-07 |
| Last Update Date | 2016-05-10 |
| Authorized Official Name | CLARK LEVI (MEMBER) |
| Authorized Official Telephone | 2284473823 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 3336C0002X |
Pharmacy Specialization: Clinic Pharmacy |
14440 | MS | Suppliers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| PK | 2153376 | 01 |
| Other Name | Type Code |
|---|---|
| Prime Urgent Medical Clinic | Doing Business As Name - Organization |
| Street Address |
176 GOODMAN RD W |
| City | SOUTHAVEN |
| State | MS |
| Zip Code | 38671-9405 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346257771 | Sabra F Drake | Internal Medicine | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2006-08-01 |
| 1912552100 | Lauren Robilio Collins | Nurse Practitioner | 176 Goodman Rd W, Southaven, MS 38671 | 2019-08-05 |
| 1336580190 | Jennifer Dunn | Nurse Practitioner | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2013-07-09 |
| 1316143282 | Elizabeth R Jackson | Nurse Practitioner | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2007-06-26 |
| 1578613188 | Urgent Medical Clinic Inc | Non-Pharmacy Dispensing Site | 176 Goodman Rd W, Southaven, MS 38671-9405 | 2007-01-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285196196 | Emma Tinsley-bowles Long | Social Worker | 8786 Northcreek Blvd, Bldg 8 Apt 3, Southaven, MS 38671 | 2019-04-01 |
| 1851847586 | Tiffany Lashea Jones | Adult Companion | 8755 Millbranch Road, Southaven, MS 38671 | 2016-09-01 |
| 1538526140 | Desoto Pediatric Extended Care LLC | Skilled Nursing Facility | 750 Stateline Road East, Southhaven, MS 38671 | 2016-01-27 |
| 1073983052 | Tara Burt | Physical Therapist | 7900 Airways Blvd. Building A, Suite 2, Southaven, MS 38671 | 2015-10-02 |
| 1295160463 | Ideal Community Care,llc | In Home Supportive Care | 8869 Centre Str #3, Southaven, MS 38671 | 2013-09-06 |
| 1578995692 | Gregory Charles Eakins Jr. | Optometrist | 338 Goodman Rd West, Southaven, MS 38671 | 2013-07-31 |
| 1295173169 | Erica R. Martin | Social Worker | 975 Swinnea Rdg Ste 3, Southaven, MS 38671 | 2013-06-12 |
| 1386918431 | Freds Stores of Tennessee Inc | Pharmacy | 710 Church Road, Southaven, MS 38671 | 2012-03-06 |
| 1740565613 | Mary Jeanette Scruggs | Pharmacist | 1011 Goodman Rd, Southaven, MS 38671 | 2011-10-11 |
| 1184919268 | First Pharmacy Services 5 | Pharmacy | 5185a Getwell Rd, Southaven, MS 38671 | 2011-06-16 |
| Find all providers in zip 38671 | ||||
| Taxonomy Code | 3336C0002X |
| Grouping | Suppliers |
| Classification | Pharmacy |
| Specialization | Clinic Pharmacy |
| A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. |
| 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 |
|---|---|---|---|---|
| 1417090093 | University Pavilion Pharmacy | Pharmacy | 1410 E Woodrow Wilson Dr, Jackson, MS 39216 | 2007-02-14 |
| 1518040500 | Region Iv Mh Mr Commission Phcy | Pharmacy | 2301b E Chambers Dr, Booneville, MS 38829 | 2006-10-23 |
| 1295268985 | Southern Pharmacy Clinical Management | Pharmacy | 3224 Dijon Ave, Ocean Springs, MS 39564-8520 | 2017-04-10 |
| 1912452921 | Sports Medicine Pharmacy LLC | Pharmacy | 1325 E Fortification St, Jackson, MS 39202-2442 | 2016-08-19 |
| 1689039711 | River Region Health System | Pharmacy | 2100 Highway 61 N, Pharmacy, Vicksburg, MS 39183-8211 | 2015-12-16 |
| 1578956264 | Alliance Healthcare System | Pharmacy | 1938 Crescent Meadows Dr, Holly Springs, MS 38635-7419 | 2015-03-05 |
| 1871927517 | Southeast Mississippi Rural Health Initiative, Inc. | Pharmacy | 62 Old Airport Rd, Hattiesburg, MS 39401-8382 | 2013-08-29 |
| 1689915423 | Region Iv Desoto County Pharmacy | Pharmacy | 2705 Highway 51 S, Hernando, MS 38632-2634 | 2013-03-04 |
| 1740417922 | Coastal Family Health Center, Inc. | Pharmacy | 1025 Division St, Ste A, Biloxi, MS 39530-2906 | 2009-06-16 |
| 1508072273 | Foot Solutions LLC | Pharmacy | 120 Market St, Woodland, MS 39776-9104 | 2007-05-16 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on PRIME URGENT MEDICAL CLINIC.
| 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.