Metro Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

02268 01.1 Issued in MS

Legal business name

METRO PHARMACY INC

Practice address

1815 Hospital Dr
Jackson, MS 39204-3425

Phone

(601) 346-5567

Fax

(601) 346-7371

NPI assigned

Feb 12, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Glenn D Brantley, PHARMACIST

Title

Vice President. Secretary Treasure

Phone

(601) 346-5567

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1171238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1187654400000",
    "number": "1124169057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1815 HOSPITAL DR",
            "address_2": "SUITE 118",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043425",
            "telephone_number": "601-346-5567",
            "fax_number": "601-346-7371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1815 HOSPITAL DR",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "392043425",
            "telephone_number": "601-346-5567",
            "fax_number": "601-346-7371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-12",
        "last_updated": "2007-08-21",
        "status": "A",
        "authorized_official_last_name": "BRANTLEY",
        "authorized_official_first_name": "GLENN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT. SECRETARY TREASURE",
        "authorized_official_telephone_number": "601-346-5567",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PHARMACIST"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "02268 01.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "2517021",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030365",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 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.