NPIMap

Organization Active NPI

Peyten, LTD.

  • Pharmacist
  • Canton, MS
National Provider Identifier
1093701526
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E7245 Issued in MS
Legal business name
PEYTEN, LTD.
Practice address
1883 Highway 43 S
Suite a
Canton, MS 39046-8405
Phone
(601) 407-1440
Fax
(601) 407-1441
NPI assigned
Sep 20, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Dr. Julia C Tennin, PHARM DNPI 1598734576
Title
Owner/Pharmacist
Phone
(601) 407-1440

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
PharmacistGroup: 193400000X SINGLE SPECIALTY GROUP 183500000X E7245 MS Primary

Addresses

Primary practice location

1883 Highway 43 S
Suite a
Canton, MS 39046-8405

Mailing address

1883 Highway 43 S
Suite a
Canton, MS 39046-8405
Phone (601) 407-1440

Other identifiers 2

IdentifierTypeStateIssuer
07775397MedicaidMS
08673232MedicaidMS

Other names 1

  • Clinic Pharmacy Doing business as

National Provider Directory

National Provider Directory

Locations

1883 Highway 43 S
Ste A
Canton, MS 39046
Phone (601) 407-1440

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": "1127174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093701526",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1883 HIGHWAY 43 S",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390468405",
            "telephone_number": "601-407-1440",
            "fax_number": "601-407-1441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1883 HIGHWAY 43 S",
            "address_2": "SUITE A",
            "city": "CANTON",
            "state": "MS",
            "postal_code": "390468405",
            "telephone_number": "601-407-1440",
            "fax_number": "601-407-1441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEYTEN, LTD.",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-20",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TENNIN",
        "authorized_official_first_name": "JULIA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "601-407-1440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARM D"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E7245",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07775397",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08673232",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Clinic Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Canton, MS

Sources for this page

  • 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.