Midsouth Medical Specialties, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

MIDSOUTH MEDICAL SPECIALTIES, LLC

Doing business as

Super Drugs

Practice address

5500 Central Avenue
Hot Springs, AR 71913

Phone

(014) 639-9225

Fax

(501) 463-9925

NPI assigned

May 20, 2014

Last updated

Jul 6, 2020By the provider in NPPES

Organization subpart

Yes

Parent organization

MIDSOUTH MEDICAL SPECIALTIES, LLCAs reported in NPPES

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

Authorized official

Name

Eddie O'Bannon

Title

Owner

Phone

(901) 262-4317

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• Super Drugs Doing business as

Part of

Misdouth Medical Specialties LLC

Locations

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

{
    "created_epoch": "1400544000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1593993600000",
    "number": "1215349667",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 563",
            "city": "HERNANDO",
            "state": "MS",
            "postal_code": "386320563",
            "telephone_number": "501-463-9922",
            "fax_number": "501-463-9925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 CENTRAL AVENUE",
            "city": "HOT SPRINGS",
            "state": "AR",
            "postal_code": "71913",
            "telephone_number": "014-639-9225",
            "fax_number": "501-463-9925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDSOUTH MEDICAL SPECIALTIES, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MIDSOUTH MEDICAL SPECIALTIES, LLC",
        "enumeration_date": "2014-05-20",
        "last_updated": "2020-07-06",
        "certification_date": "2020-07-06",
        "status": "A",
        "authorized_official_last_name": "O'BANNON",
        "authorized_official_first_name": "EDDIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-262-4317"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "208246407",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Super Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joseph Michael Messina, LCSW
• Teresa Messina, LCSW
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• Michelle D. Mitchell, MD PA (Serenity Center for Women)
• Midlife Health and Wellness
• Midsouth Medical Specialties, LLC (National Park Pharmacy)
• Midsouth Medical Specialties, LLC (Oak Park Pharmacy)
• Midstate Medical Services PA
• Mike S McFarland Mdpa
• John Miles, CRNA

• Community/Retail Pharmacy in Hot Springs, AR
• Providers in Hot Springs, AR by specialty
• Community/Retail Pharmacy in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 6, 2020; 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.