Organization Active NPI

Beaumont Drugs LLC

Doing business as Beaumont Drugs

  • Community/Retail Pharmacy
  • Beaumont, MS
National Provider Identifier
1114382389
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
01718/1.1 Issued in MS
Legal business name
BEAUMONT DRUGS LLC
Doing business as
Beaumont Drugs
Practice address
881 Highway 198
Beaumont, MS 39423-2070
Phone
(601) 784-3313
Fax
(601) 784-3310
NPI assigned
Dec 15, 2015
Last updated
May 17, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 17, 2016

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

Authorized official

Name
Rocky McGarityNPI 1215050257
Title
RPH/President/Owner
Phone
(601) 947-4941

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 01718/1.1 MS Primary

Addresses

Primary practice location

881 Highway 198
Beaumont, MS 39423-2070

Mailing address

103 W Frontage Rd
Ste a
Lucedale, MS 39452-5836
Phone (601) 947-4941

Other identifiers 2

IdentifierTypeStateIssuer
2155958OtherPK
00030261MedicaidMS

Other names 1

  • Beaumont Drugs Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20161019000315 MS Part B Supplier - Mass Immunization (Roster Biller Only) 5092003301 Practice locations: Beaumont, MS

National Provider Directory

National Provider Directory

Locations

103 W Frontage Rd
#A
Lucedale, MS 39452
Phone (601) 947-4941

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1450137600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463443200000",
    "number": "1114382389",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "103 W FRONTAGE RD",
            "address_2": "STE A",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394525836",
            "telephone_number": "601-947-4941",
            "fax_number": "601-247-0070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "881 HIGHWAY 198",
            "city": "BEAUMONT",
            "state": "MS",
            "postal_code": "394232070",
            "telephone_number": "601-784-3313",
            "fax_number": "601-784-3310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAUMONT DRUGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-15",
        "last_updated": "2016-05-17",
        "status": "A",
        "authorized_official_last_name": "MCGARITY",
        "authorized_official_first_name": "ROCKY",
        "authorized_official_title_or_position": "RPH/PRESIDENT/OWNER",
        "authorized_official_telephone_number": "601-947-4941"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "01718/1.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2155958",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030261",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaumont Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Beaumont, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.