Maegen Felicity Besancon
Individual provider Active NPI Pharmacist · Waveland, MS
NPI 1114538006 · NPPES record last updated Aug 13, 2020
Key facts
- NPI
- 1114538006
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 15117 (MS)
- Practice address
- 348 Highway 90
Waveland, MS 39576-2672 - Phone
- (228) 467-4436
- NPI assigned
- Aug 13, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15117 | MS | MD | Pharmacist |
| E-15117 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current |
Accepting new patients | |
| Walgreen Co | Past |
Accepting new patients |
Locations
348 Highway 90
Waveland, MS 39576
Phone (228) 467-4436
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist |
183500000X | E-15117 | MS | |
| Pharmacist | 183500000X | 15117 | MS | Yes |
Addresses
Primary practice location
348 Highway 90
Waveland, MS 39576-2672
Mailing address
514 John Baptiste St
Bay St Louis, MS 39520-4708
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | Pharmacy |
Other providers in Waveland, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 13, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.