TLL&W Inc Dba Buckleys Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00509 Issued in MS

Legal business name

TLL&W INC DBA BUCKLEYS PHARMACY

Practice address

301 Hospital Dr
Cleveland, MS 38732-2358

Phone

(662) 843-3654

Fax

(662) 843-3622

NPI assigned

Feb 20, 2007

Organization subpart

No

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

Authorized official

Name

Cullie Taylor Roberts Jr., R.PH.NPI 1063557791

Title

Pharmacist-Owner

Phone

(662) 843-3654

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• BUCKLEYS PHARMACY Doing business as

Locations

Practitioners 1

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

• Cullie Taylor Roberts Jr., R.PH.

  • Pharmacist
  • Cleveland, MS
  • NPI 1063557791
  NPD (past) Authorized official

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

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1063557718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322358",
            "telephone_number": "662-843-3654",
            "fax_number": "662-843-3622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 HOSPITAL DR",
            "city": "CLEVELAND",
            "state": "MS",
            "postal_code": "387322358",
            "telephone_number": "662-843-3654",
            "fax_number": "662-843-3622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TLL&W INC DBA BUCKLEYS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ROBERTS",
        "authorized_official_first_name": "CULLIE",
        "authorized_official_middle_name": "TAYLOR",
        "authorized_official_title_or_position": "PHARMACIST-OWNER",
        "authorized_official_telephone_number": "662-843-3654",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00509",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2515192",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030389",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BUCKLEYS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Cleveland, MS
• Providers in Cleveland, 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 Aug 22, 2020; 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.