Active NPI
Greenwood Downtown Drugs Inc
- Community/Retail Pharmacy
- Greenwood, MS
National Provider Identifier
1003060047
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 11389/1.1
- Legal business name
- GREENWOOD DOWNTOWN DRUGS INC
- Practice address
- 105 Carrollton Ave
Greenwood, MS 38930-4436 - Phone
- (662) 453-4401
- Fax
- (662) 453-2527
- NPI assigned
- Nov 4, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Guy Phillips
- Title
- President and Owner
- Phone
- (662) 887-4135
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | |||
| Community/Retail Pharmacy | 3336C0003X | 11389/1.1 | MS | Primary |
Addresses
Primary practice location
105 Carrollton Ave
Greenwood, MS 38930-4436
Mailing address
105 Carrollton Ave
Greenwood, MS 38930-4436
Phone (662) 453-4401
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2135379 | Other | PK |
Other names 1
- Greenwood Downtown Drugs Inc
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MS
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20200713003144 | MS | Part B Supplier - Mass Immunization (Roster Biller Only) | 2163845876 | Practice locations: Greenwood, MS |
National Provider Directory
National Provider Directory- Tax ID family
- Downtown Drugs LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Long Term Care Pharmacy
- Greenwood, MS
- NPI 1962280065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1225756800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1695081600000",
"number": "1003060047",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "105 CARROLLTON AVE",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389304436",
"telephone_number": "662-453-4401",
"fax_number": "662-453-2527"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 CARROLLTON AVE",
"city": "GREENWOOD",
"state": "MS",
"postal_code": "389304436",
"telephone_number": "662-453-4401",
"fax_number": "662-453-2527"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "GREENWOOD DOWNTOWN DRUGS INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-11-04",
"last_updated": "2023-09-19",
"certification_date": "2023-09-19",
"status": "A",
"authorized_official_last_name": "PHILLIPS",
"authorized_official_first_name": "GUY",
"authorized_official_title_or_position": "PRESIDENT AND OWNER",
"authorized_official_telephone_number": "662-887-4135"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": null,
"license": null,
"primary": false
},
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "MS",
"license": "11389/1.1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PK",
"identifier": "2135379",
"state": null
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Greenwood Downtown Drugs Inc",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Greenwood, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.