NPIMap

Organization Active NPI

Southern Pharmaceutical Corporation

  • Oxygen Equipment & Supplies (DME)
  • Philadelphia, MS
National Provider Identifier
1093809774
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oxygen Equipment & Supplies (DME)Taxonomy code 332BX2000X
License
05830/11.1 Issued in MS
Legal business name
SOUTHERN PHARMACEUTICAL CORPORATION
Practice address
10501 Road 375
Philadelphia, MS 39350
Phone
(601) 650-9699
Fax
(601) 650-9262
NPI assigned
Oct 3, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Authorized official

Name
Gregory J Crawford
Title
President
Phone
(859) 441-8876

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Oxygen Equipment & Supplies (DME) 332BX2000X 05830/11.1 MS Primary

Addresses

Primary practice location

10501 Road 375
Philadelphia, MS 39350

Mailing address

1019 Town Dr
Highland Heights, KY 41076-9114
Phone (859) 441-8876

Other identifiers 1

IdentifierTypeStateIssuer
07533263MedicaidMS

Other names 1

  • Quipt Home Medical Columbus Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100930031072 MS DME Supplier - Medical Supply CompanyDME Supplier - Medical Supply Company With Respiratory TherapistDME Supplier - Oxygen & EquipmentDME Supplier - Orthotic Personnel 9537286513 Practice locations: Philadelphia, MS

Other NPIs with the same Medicare PAC ID 7

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

National Provider Directory

National Provider Directory
Tax ID family
Southern Pharmaceutical Corporation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

10551 Outdoor Way
Ste H
Gulfport, MS 39503
Phone (228) 868-9335

17220 E Main St
Ste C
Louisville, MS 39339
Phone (662) 773-4557

10501 Road 375
Philadelphia, MS 39350
Phone (601) 650-9699

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1726444800000",
    "number": "1093809774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 TOWN DR",
            "city": "HIGHLAND HEIGHTS",
            "state": "KY",
            "postal_code": "410769114",
            "telephone_number": "859-441-8876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10501 ROAD 375",
            "city": "PHILADELPHIA",
            "state": "MS",
            "postal_code": "39350",
            "telephone_number": "601-650-9699",
            "fax_number": "601-650-9262"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PHARMACEUTICAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A",
        "authorized_official_last_name": "CRAWFORD",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "859-441-8876"
    },
    "taxonomies": [
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MS",
            "license": "05830/11.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07533263",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Quipt Home Medical Columbus",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Philadelphia, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2024; 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.