NPIMap

Organization Active NPI

Brentwood Acquisition Pharmacy

  • Institutional Pharmacy
  • Flowood, MS
National Provider Identifier
1023549060
Registry record updated Mar 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
05066/3.1 Issued in MS
Legal business name
BRENTWOOD ACQUISITION PHARMACY
Practice address
3531 Lakeland Dr
Flowood, MS 39232-8049
Phone
(601) 936-7845
Fax
(601) 936-7846
NPI assigned
Mar 22, 2017
Organization subpart
Yes
Parent organization
BRENTWOOD ACQUISITIONAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 11, 2019

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

Authorized official

Name
Samantha Medina, PHARM.D
Title
Director of Pharmacy
Phone
(601) 936-7845

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 05066/3.1 MS Primary

Addresses

Primary practice location

3531 Lakeland Dr
Flowood, MS 39232-8049

Mailing address

3531 Lakeland Dr
Flowood, MS 39232-8049
Phone (601) 936-7845

National Provider Directory

National Provider Directory
Tax ID family
Brentwood Acquisition Pharmacy3 organizations share this tax ID, including this one
Part of
Brentwood Acquisition Pharmacy

Other organizations with this tax ID 2

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

NPI Registry JSON

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

{
    "created_epoch": "1490140800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1552262400000",
    "number": "1023549060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3531 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328049",
            "telephone_number": "601-936-7845",
            "fax_number": "601-936-7846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3531 LAKELAND DR",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392328049",
            "telephone_number": "601-936-7845",
            "fax_number": "601-936-7846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRENTWOOD ACQUISITION PHARMACY",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BRENTWOOD ACQUISITION",
        "enumeration_date": "2017-03-22",
        "last_updated": "2019-03-11",
        "status": "A",
        "authorized_official_last_name": "MEDINA",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "DIRECTOR OF PHARMACY",
        "authorized_official_telephone_number": "601-936-7845",
        "authorized_official_credential": "PHARM.D"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MS",
            "license": "05066/3.1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2019; 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.