Southern Discount Drugs of Charleston Inc

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

06473/11.1 Issued in MS

Legal business name

SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC

Doing business as

The Diabetic Shoppe

Practice address

1068 Factory Dr
Charleston, MS 38921-6620

Phone

(662) 647-6601

Fax

(662) 647-2411

NPI assigned

Nov 30, 2005

Last updated

Jul 11, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Robert Salmon, RPH

Title

Pharmacist

Phone

(662) 647-2591

Specialties & licenses 8

Addresses

Other names 1

• The Diabetic Shoppe Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1104800440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1068 FACTORY DR",
            "city": "CHARLESTON",
            "state": "MS",
            "postal_code": "389216620",
            "telephone_number": "662-647-6601",
            "fax_number": "662-647-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1068 FACTORY DR",
            "city": "CHARLESTON",
            "state": "MS",
            "postal_code": "389216620",
            "telephone_number": "662-647-6601",
            "fax_number": "662-647-2411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-30",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "SALMON",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "662-647-2591",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "06473/11.1",
            "primary": true
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AL",
            "license": "1022",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "UT",
            "license": "8226997-1714",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AR",
            "license": "056014",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "ID",
            "license": "DME18182",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "OR",
            "license": "NPC-0003778",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NV",
            "license": "MP00957",
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "AZ",
            "license": "P013728",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Diabetic Shoppe",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Diabetic Shoppe",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ronal Roberson, DMD
• Angela C Rounds
• Angela Bailey Rowsey
• Anne Wilson Selby, FNP
• Shana Belle Smith, FNP-C
• Southern Discount Drugs of Charleston Inc.
• Square Drugs, LLC
• Tallahatchie Eyecare, PLLC
• Tallahatchie General Hospital (Charleston Rural Health Clinic)
• Tallahatchie General Hospital

• Durable Medical Equipment & Medical Supplies in Charleston, MS
• Providers in Charleston, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.