NPIMap

Organization Active NPI

City Drugs of Crystal Springs, Inc.

Doing business as City Drugs

  • Community/Retail Pharmacy
  • Crystal Springs, MS
National Provider Identifier
1205802980
Registry record updated Aug 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
01756/01.1 Issued in MS
Legal business name
CITY DRUGS OF CRYSTAL SPRINGS, INC.
Doing business as
City Drugs
Practice address
113 Bo Bo Dr
Crystal Springs, MS 39059-2741
Phone
(601) 892-4121
Fax
(601) 892-1598
NPI assigned
Feb 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2016

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

Authorized official

Name
Mr. Reagan L Brown, RPHNPI 1295299501
Title
Pharmacist
Phone
(601) 892-4121

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
Community/Retail Pharmacy 3336C0003X 01756/01.1 MS Primary
Long Term Care Pharmacy 3336L0003X 01756/1.1 MS

Addresses

Primary practice location

113 Bo Bo Dr
Crystal Springs, MS 39059-2741

Mailing address

113 Bo Bo Dr
Crystal Springs, MS 39059-2741
Phone (601) 892-4121

Other identifiers 2

IdentifierTypeStateIssuer
00030165MedicaidMS
2501624OtherMSNCPDP NUMBER

Other names 1

  • City Drugs Doing business as

National Provider Directory

National Provider Directory

Locations

113 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-4121

Practitioners & affiliated clinicians

Practitioners 8

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

NPI Registry JSON

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1470787200000",
    "number": "1205802980",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "113 BO BO DR",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592741",
            "telephone_number": "601-892-4121",
            "fax_number": "601-892-1598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 BO BO DR",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390592741",
            "telephone_number": "601-892-4121",
            "fax_number": "601-892-1598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITY DRUGS OF CRYSTAL SPRINGS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2016-08-10",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "REAGAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "601-892-4121",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "01756/01.1",
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MS",
            "license": "01756/1.1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030165",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP NUMBER",
            "identifier": "2501624",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "City Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Crystal Springs, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2016; 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.