Back Bay Drugs LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

BACK BAY DRUGS LLC

Practice address

10437 Lamey Bridge Rd
Suite a
Diberville, MS 39540-2709

Phone

(228) 396-2228

Fax

(228) 396-2257

NPI assigned

Oct 18, 2006

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. William T Aycock, R.PH.

Title

Pharmacist

Phone

(228) 396-2257

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161129600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1285715037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10437 LAMEY BRIDGE RD",
            "address_2": "SUITE A",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395402709",
            "telephone_number": "228-396-2228",
            "fax_number": "228-396-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10437 LAMEY BRIDGE RD",
            "address_2": "SUITE A",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395402709",
            "telephone_number": "228-396-2228",
            "fax_number": "228-396-2257"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BACK BAY DRUGS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-18",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "AYCOCK",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "228-396-2257",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330637",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Community/Retail Pharmacy in D'Iberville, MS
• Providers in D'Iberville, 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 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.