Kipa Inc. Dba Rodgers Family Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0219301.1 Issued in MS

Legal business name

KIPA INC. DBA RODGERS FAMILY PHARMACY

Practice address

130 W Central Ave
Petal, MS 39465-2314

Phone

(601) 582-8351

Fax

(601) 545-7342

NPI assigned

Mar 1, 2007

Last updated

Aug 22, 2020By 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. Duke Kimbrell Rodgers, RPH

Title

Owner

Phone

(601) 582-8351

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1225166184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 W CENTRAL AVE",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652314",
            "telephone_number": "601-582-8351",
            "fax_number": "601-545-7342"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 W CENTRAL AVE",
            "city": "PETAL",
            "state": "MS",
            "postal_code": "394652314",
            "telephone_number": "601-582-8351",
            "fax_number": "601-545-7342"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KIPA INC. DBA RODGERS FAMILY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "RODGERS",
        "authorized_official_first_name": "DUKE",
        "authorized_official_middle_name": "KIMBRELL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-582-8351",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "0219301.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2516562",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030167",
            "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 22, 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.