NPIMap

Organization Active NPI

C and K Pharmacy

  • Community/Retail Pharmacy
  • Grenada, MS
National Provider Identifier
1083036016
Registry record updated Aug 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
12961/1.1 Issued in MS
Legal business name
C AND K PHARMACY
Practice address
350 Sunset Dr
Grenada, MS 38901-4613
Phone
(662) 307-2221
Fax
(662) 307-2438
NPI assigned
Jan 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2021

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

Authorized official

Name
Christy Hudson
Title
President
Phone
(662) 307-2221

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 12961/1.1 MS Primary

Addresses

Primary practice location

350 Sunset Dr
Grenada, MS 38901-4613

Mailing address

350 Sunset Dr
Grenada, MS 38901-4613
Phone (662) 307-2221

Other identifiers 2

IdentifierTypeStateIssuer
2143618OtherPK
08188783MedicaidMS

Other names 1

  • Quick Care Pharmacy and Wellness Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150225000699 MS Part B Supplier - Pharmacy 4284958968 Practice locations: Grenada, MS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

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": "1389312000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630281600000",
    "number": "1083036016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 SUNSET DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014613",
            "telephone_number": "662-307-2221",
            "fax_number": "662-307-2438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "350 SUNSET DR",
            "city": "GRENADA",
            "state": "MS",
            "postal_code": "389014613",
            "telephone_number": "662-307-2221",
            "fax_number": "662-307-2438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "C AND K PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-10",
        "last_updated": "2021-08-30",
        "certification_date": "2021-08-30",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "CHRISTY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-307-2221"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "12961/1.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2143618",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08188783",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quick Care Pharmacy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Quick Care Pharmacy and Wellness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grenada, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.