NPIMap

Organization Active NPI

Northeast Pharmaceuticals, Inc.

  • Community/Retail Pharmacy
  • Brandon, MS
National Provider Identifier
1295013530
Registry record updated Aug 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
09098 Issued in MS
Legal business name
NORTHEAST PHARMACEUTICALS, INC.
Practice address
608 Marquette Road
Brandon, MS 39042
Phone
(334) 356-7627
Fax
(334) 356-8347
NPI assigned
Aug 3, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2011

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

Authorized official

Name
Krystal L Mims
Title
Director of Operations
Phone
(334) 356-7627

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X 09098 MS Primary

Addresses

Primary practice location

608 Marquette Road
Brandon, MS 39042

Mailing address

608 Marquette Rd
Brandon, MS 39042
Phone (334) 356-7627

National Provider Directory

National Provider Directory
Tax ID family
Northeast Pharmaceuticals Inc8 organizations share this tax ID, including this one

Other organizations with this tax ID 7

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1312329600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312502400000",
    "number": "1295013530",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 MARQUETTE RD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39042",
            "telephone_number": "334-356-7627",
            "fax_number": "334-356-8347"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "608 MARQUETTE ROAD",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "39042",
            "telephone_number": "334-356-7627",
            "fax_number": "334-356-8347"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST PHARMACEUTICALS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-08-03",
        "last_updated": "2011-08-05",
        "status": "A",
        "authorized_official_last_name": "MIMS",
        "authorized_official_first_name": "KRYSTAL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "334-356-7627"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "09098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2011; 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.