City Drug, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

CITY DRUG, LLC

Practice address

113 Bo Bo Dr
Crystal Springs, MS 39059-2741

Phone

(601) 892-4121

Fax

(601) 892-1598

NPI assigned

Oct 17, 2018

Organization subpart

No

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

Authorized official

Name

Reagan Lindsay Brown, RPHNPI 1295299501

Title

Member

Phone

(601) 892-4121

Specialties & licenses 4

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MS3 enrollments

Enrollment records 3

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Practitioners 8

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

• Reagan Brown

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1295299501
  NPD Authorized official
• Madeline Carter

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1710849518
  NPD (past)
• Donald Lonzo Comfort II, PHARMD

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1790360493
  NPD (past)
• Tyler Lee Hendrix, PHARM D

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1437614351
  NPD (past)
• Henry L McGuire, RPH

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1003371196
  NPD (past)
• Alexandra Jane Pruitt

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1972477578
  NPD (past)
• William T Walker, RPH

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1902361074
  NPD (past)
• Amanda C Wilson, RPH

  • Pharmacist
  • Crystal Springs, MS
  • NPI 1962055053
  NPD (past)

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1551225600000",
    "number": "1225504269",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 193",
            "city": "CRYSTAL SPRINGS",
            "state": "MS",
            "postal_code": "390590193",
            "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 DRUG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-17",
        "last_updated": "2019-02-27",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "REAGAN",
        "authorized_official_middle_name": "LINDSAY",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "601-892-4121",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "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
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030165",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brendan Gregory Burgess
• Emily-Kate Carter, PHARMD
• Madeline Carter
• CDS Home Care, Inc
• Annetter Christmas
• City Drugs of Crystal Springs, Inc.
• Donald Lonzo Comfort II, PHARMD
• Comforting Hands Healthcare
• Community Connections & Networks LLC
• Copiah Community Care Center LLC

• Community/Retail Pharmacy in Crystal Springs, MS
• Providers in Crystal Springs, 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 Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.