Medi Center Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MEDI CENTER PHARMACY

Practice address

1629 N State St
Clarksdale, MS 38614-6617

Phone

(662) 624-6561

Fax

(662) 627-2845

NPI assigned

Dec 4, 2006

Organization subpart

No

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

Authorized official

Name

Audric Chow, PHRM

Title

Owner

Phone

(662) 624-6561

Specialties & licenses 2

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186963200000",
    "number": "1093883233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1629 N STATE ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146617",
            "telephone_number": "662-624-6561",
            "fax_number": "662-624-6562"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1629 N STATE ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386146617",
            "telephone_number": "662-624-6561",
            "fax_number": "662-627-2845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDI CENTER PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2007-08-13",
        "status": "A",
        "authorized_official_last_name": "CHOW",
        "authorized_official_first_name": "AUDRIC",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-624-6561",
        "authorized_official_credential": "PHRM"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "01632011",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00095109",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2511043",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alia Marguerite McCoy, D.C.
• Kaylea Byrd McCraw
• Angelia McDowell, DNP, APRN, PMHNP-BC
• Curtisha McGregory, M.S.
• Tiffany McNeal
• Medical Oncology Inc
• Carrie Cope Melton
• Memorial Hospice Inc
• Ramon Merritte
• Eric H Messenger

• Community/Retail Pharmacy in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2007; 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.