NPIMap

Organization Active NPI

Brister Brothers Pharmacy DME

  • Durable Medical Equipment & Medical Supplies
  • Grenada, MS
National Provider Identifier
1003083544
Registry record updated May 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BRISTER BROTHERS PHARMACY DME
Practice address
1117 Sunset Dr
Suite 102
Grenada, MS 38901-4080
Phone
(662) 226-1642
Fax
(662) 226-8585
NPI assigned
May 14, 2008
Last updated
May 14, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
BRISTER BROTHERS INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on May 14, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Ward Brister, RPH
Title
Owner
Phone
(662) 226-1642

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1117 Sunset Dr
Suite 102
Grenada, MS 38901-4080

Mailing address

1117 Sunset Dr
Suite 102
Grenada, MS 38901-4080
Phone (662) 226-1642

National Provider Directory

National Provider Directory
Tax ID family
Brister Brothers Inc2 organizations share this tax ID, including this one
Part of
Brister Brothers Inc

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1117 Sunset Dr
Ste 102
Grenada, MS 38901
Phone (662) 226-1642

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1210723200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1210723200000",
    "number": "1003083544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1117 SUNSET DR",
            "address_2": "SUITE 102",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014080",
            "telephone_number": "662-226-1642",
            "fax_number": "662-226-8585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1117 SUNSET DR",
            "address_2": "SUITE 102",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014080",
            "telephone_number": "662-226-1642",
            "fax_number": "662-226-8585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRISTER BROTHERS PHARMACY DME",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRISTER BROTHERS INC",
        "enumeration_date": "2008-05-14",
        "last_updated": "2008-05-14",
        "status": "A",
        "authorized_official_last_name": "BRISTER",
        "authorized_official_first_name": "WARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-226-1642",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grenada, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.