Dominique Fitch, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

E14646 Issued in MS

Practice address

2601 Highway 90
Gautier, MS 39553-5167

Phone

(228) 497-8110

NPI assigned

Sep 7, 2016

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Walgreen Co

  • Pharmacy
  • Gautier, MS
  • NPI 1821289398
  NPD (past)
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1473206400000",
    "number": "1053868919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3525 VAN CLEAVE DR",
            "city": "MERAUX",
            "state": "LA",
            "postal_code": "700758024",
            "telephone_number": "504-909-3025"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 HIGHWAY 90",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535167",
            "telephone_number": "228-497-8110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITCH",
        "first_name": "DOMINIQUE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E14646",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "LA",
            "license": "PST. 021620",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peggy Lynn Fendley, M.ED.
• Mary Elizabeth Fenech, MS
• Lashundra Finley, B.S.
• Kemymon Firley
• Amanda Leigh Fisher, BA
• Victoria Rose Fletcher, B.S.
• Yolanda Elizabeth Flint
• Martin Talmadge Flurry, BS
• Melissa Ann Foreman
• Joseph Andrew Forsman, B.A. PSYCHOLOGY

• Pharmacist in Gautier, MS
• Providers in Gautier, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2016; 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.