Organization Active NPI

National Pharmacy of Mississippi, LLC

  • Long Term Care Pharmacy
  • Ridgeland, MS
National Provider Identifier
1063971539
Registry record updated Oct 21, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
NATIONAL PHARMACY OF MISSISSIPPI, LLC
Practice address
371B Highland Colony Pkwy
Ridgeland, MS 39157-6035
Phone
(769) 235-4141
Fax
(769) 235-7162
NPI assigned
Mar 14, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2019

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

Authorized official

Name
Samuel Thomas Mahfouz
Title
Managing Member
Phone
(769) 235-4141

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

371B Highland Colony Pkwy
Ridgeland, MS 39157-6035

Mailing address

371B Highland Colony Pkwy
Ridgeland, MS 39157-6035
Phone (769) 235-4141

National Provider Directory

National Provider Directory

Locations

371B Highland Colony Pkwy
Ridgeland, MS 39157
Phone (318) 445-8770

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1552521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1571616000000",
    "number": "1063971539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "371B HIGHLAND COLONY PKWY",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391576035",
            "telephone_number": "769-235-4141",
            "fax_number": "769-235-7162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "371B HIGHLAND COLONY PKWY",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391576035",
            "telephone_number": "769-235-4141",
            "fax_number": "769-235-7162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NATIONAL PHARMACY OF MISSISSIPPI, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-03-14",
        "last_updated": "2019-10-21",
        "status": "A",
        "authorized_official_last_name": "MAHFOUZ",
        "authorized_official_first_name": "SAMUEL",
        "authorized_official_middle_name": "THOMAS",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "769-235-4141"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.