Clint's Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

3336C0003X Issued in MS

Legal business name

CLINT'S PHARMACY INC

Practice address

515 Brookway Blvd
Brookhaven, MS 39601-3266

Phone

(601) 833-3160

NPI assigned

Mar 16, 2010

Last updated

Mar 16, 2010By 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. Clint Eugene Bane III

Title

Owner/Pharmacist

Phone

(601) 833-3160

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1268697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1268697600000",
    "number": "1245554559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 BROOKWAY BLVD",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013266",
            "telephone_number": "601-833-3160"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 BROOKWAY BLVD",
            "city": "BROOKHAVEN",
            "state": "MS",
            "postal_code": "396013266",
            "telephone_number": "601-833-3160"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINT'S PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-03-16",
        "last_updated": "2010-03-16",
        "status": "A",
        "authorized_official_last_name": "BANE",
        "authorized_official_first_name": "CLINT",
        "authorized_official_middle_name": "EUGENE",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "601-833-3160",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "3336C0003X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Dean Chappell Jr., FNP-C
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• Jeffrey G Clark, M.D.
• Candice Nicole Cliburn, NURSE PRACTITIONER
• Crystal Alane Cloy, PMHNP
• Dominique Collins
• Tiffany P Collins, ADMINISTRATOR
• Porcia Combs
• Community Wellness Group LLC

• Community/Retail Pharmacy in Brookhaven, MS
• Providers in Brookhaven, 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 Mar 16, 2010; 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.