NPIMap

Organization Active NPI

South Central Regional Medical Center

Doing business as South Central Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Laurel, MS
National Provider Identifier
1083657381
Registry record updated Jun 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Doing business as
South Central Outpatient Pharmacy
Practice address
1220 Jefferson St Ste 2
Laurel, MS 39440-4355
Phone
(601) 426-4961
Fax
(601) 426-4909
NPI assigned
Jun 14, 2006
Last updated
Jun 22, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 22, 2026

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

Authorized official

Name
Stephen East
Title
Cfo
Phone
(601) 399-6144

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X NU Primary
Long Term Care Pharmacy 3336L0003X NU

Addresses

Primary practice location

1220 Jefferson St Ste 2
Laurel, MS 39440-4355

Mailing address

PO Box 607
Laurel, MS 39441-0607
Phone (601) 426-4961

Other identifiers 2

IdentifierTypeStateIssuer
2043274OtherPK
200023046MedicaidMS

Other names 1

  • South Central Outpatient Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20251108000045 MS Part B Supplier - Pharmacy 8325946411 Practice locations: Laurel, MS

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
South Central Reg Med C27 organizations share this tax ID, including this one
Part of
South Central Reg Med C

Other organizations with this tax ID 26

Organizations that report the same tax identification number in the National Provider Directory.

View all 26

Locations

1205 B Ave
Ellisville, MS 39437
Phone (601) 477-2226

305 E Ivy St
Ellisville, MS 39437
Phone (601) 477-9381

300 Cahal St
Ste A
Hattiesburg, MS 39401
Phone (601) 582-9157

1107 W 6th St
Laurel, MS 39440
Phone (601) 426-9614

1220 Jefferson St
Ste 2
Laurel, MS 39440
Phone (601) 426-4000

1410 Jefferson St
Laurel, MS 39440
Phone (601) 264-3937

1440 Jefferson St
Laurel, MS 39440
Phone (601) 428-0577

2260 Highway 15 N
Laurel, MS 39440
Phone (601) 399-6340

234 S 12th Ave
Ste A
Laurel, MS 39440
Phone (601) 326-2599

234 S 12th Ave
Ste B
Laurel, MS 39440
Phone (601) 426-2886

30 Circle J Dr
Laurel, MS 39440
Phone (601) 425-0092

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jones County Rest HomeEllisville, MS, CCN 255336 Skilled nursing facility Operational/Managerial Control (100%) Apr 10, 2010
Comfort Care Nursing CenterLaurel, MS, CCN 255352 Skilled nursing facility Operational/Managerial Control (100%) Aug 1, 1994
Comfort Care Home HealthLaurel, MS, CCN 257099 Home health agency Operational/Managerial Control (100%) Jul 1, 1991
Comfort Care HospiceLaurel, MS, CCN 251512 Hospice Operational/Managerial Control (100%) Jul 18, 1992
South Central Family Medicine & Urgent CareLaurel, MS, CCN 258581 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2014
South Central PediatricsLaurel, MS, CCN 258510 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
Ellisville Pediatric ClinicEllisville, MS, CCN 253437 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
South Central Primary Care ServicesLaurel, MS, CCN 258649 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2020
South Central Urgent CareLaurel, MS, CCN 258688 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2020
Jul 1, 2025

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 19

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782086400000",
    "number": "1083657381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 607",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394410607",
            "telephone_number": "601-426-4961",
            "fax_number": "601-426-4909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JEFFERSON ST STE 2",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "394404355",
            "telephone_number": "601-426-4961",
            "fax_number": "601-426-4909"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2006-06-14",
        "last_updated": "2026-06-22",
        "certification_date": "2026-06-22",
        "status": "A",
        "authorized_official_last_name": "EAST",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-399-6144"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2043274",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200023046",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.