Petal Drug Company, Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

E08925 Issued in MS

Legal business name

PETAL DRUG COMPANY, INC.

Practice address

201 Old Richton Rd
Petal, MS 39465-2943

Phone

(601) 545-3141

Fax

(601) 544-7404

NPI assigned

Sep 13, 2006

Last updated

Mar 25, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. David R Ratcliff, RPH

Title

Pharmacist in Charge

Phone

(601) 545-3141

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1711324800000",
    "number": "1215032420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 OLD RICHTON RD",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652943",
            "telephone_number": "601-545-3141",
            "fax_number": "601-544-7404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 OLD RICHTON RD",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652943",
            "telephone_number": "601-545-3141",
            "fax_number": "601-544-7404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PETAL DRUG COMPANY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A",
        "authorized_official_last_name": "RATCLIFF",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHARMACIST IN CHARGE",
        "authorized_official_telephone_number": "601-545-3141",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E08925",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00033642",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP NUMBER",
            "identifier": "2506496",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly Nicole Patrick
• Joseph J Patterson, DPT
• Robert Perez
• Petal Chiropractic Clinic, Inc.
• Petal Dental Properties (Pediatric Dental Group of Petal)
• Petal Family Dentistry
• Petal High School
• Petal Middle School
• Petal Primary School
• Petal School Clinic

• Pharmacist in Petal, MS
• Providers in Petal, MS by specialty
• Pharmacist in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2024; 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.