Family Drug Mart of Sumrall, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

FAMILY DRUG MART OF SUMRALL, LLC

Practice address

4233 Rocky Branch Rd Ste B
Sumrall, MS 39482-4142

Phone

(769) 307-7050

Fax

(769) 307-7020

NPI assigned

Sep 24, 2019

Organization subpart

No

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

Authorized official

Name

Jose Miguel Yanez, RPH

Title

Owner

Phone

(504) 338-7992

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• FAMILY DRUG MART OF SUMRALL Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Craig Simm

  • Pharmacist
  • Sumrall, MS
  • NPI 1316539596
  NPD

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

{
    "created_epoch": "1569283200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769644800000",
    "number": "1124679873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2299 SUNSET BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704615605",
            "telephone_number": "504-338-7992",
            "fax_number": "985-265-4550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4233 ROCKY BRANCH RD STE B",
            "city": "SUMRALL",
            "state": "MS",
            "postal_code": "394824142",
            "telephone_number": "769-307-7050",
            "fax_number": "769-307-7020"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY DRUG MART OF SUMRALL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-24",
        "last_updated": "2026-01-29",
        "certification_date": "2026-01-29",
        "status": "A",
        "authorized_official_last_name": "YANEZ",
        "authorized_official_first_name": "JOSE",
        "authorized_official_middle_name": "MIGUEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "504-338-7992",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330324",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3303247",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FAMILY DRUG MART OF SUMRALL",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "FAMILY DRUG MART OF SUMRALL",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Brantley Warren Davis, COTA
• Erika Rochelle Davis
• Melody Davisson, LCSW
• Grace E Dickerson, LMFT
• Susan L Dubose, FNP-BC
• Shelby Herndon Graves, COTA
• Codie Jaclyn Green
• Beau Landry Haden, PHARMD
• Tasha F Haden, PHARMD
• Hattiesburg Clinic PA

• Community/Retail Pharmacy in Sumrall, MS
• Providers in Sumrall, 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 Jan 29, 2026; 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.