Westside Pharmacy & Gifts

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WESTSIDE PHARMACY & GIFTS

Practice address

1653 N. Coley Rd.
Tupelo, MS 38801-3880

Phone

(662) 816-5574

NPI assigned

Feb 19, 2021

Organization subpart

No

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

Authorized official

Name

John Rucker

Title

Member/Owner

Phone

(662) 346-8812

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Victoria Ellis Henley, PHARM.D.

  • Pharmacist
  • Tupelo, MS
  • NPI 1174176499
  NPD (past)

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

{
    "created_epoch": "1613692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727222400000",
    "number": "1063005155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1653 N COLEY RD",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388016931",
            "telephone_number": "662-346-8812",
            "fax_number": "662-553-4165"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1653 N. COLEY RD.",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388013880",
            "telephone_number": "662-816-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WESTSIDE PHARMACY & GIFTS",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-19",
        "last_updated": "2024-09-25",
        "certification_date": "2024-09-25",
        "status": "A",
        "authorized_official_last_name": "RUCKER",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER/OWNER",
        "authorized_official_telephone_number": "662-346-8812"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sara Westmoreland Smith
• Ashlee Nicole Westmoreland, SLP
• Luke Westphal
• Westside Dental, PLLC
• Westside Family Medical Clinic of Tupelo LLC
• Daniel Whitcomb, DO
• Amanda Leshea White
• Anna Claire White, PHARM.D.
• Brian White
• Chester White, M.D.

• Community/Retail Pharmacy in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.