NPIMap

Organization Active NPI

Specialty Pharmacy

  • Compounding Pharmacy
  • Flowood, MS
National Provider Identifier
1295147346
Registry record updated May 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Compounding PharmacyTaxonomy code 3336C0004X
License
04095/1.1 Issued in MS
Legal business name
SPECIALTY PHARMACY
Practice address
1000 Lakeland Square Ext
Suite 100
Flowood, MS 39232-7620
Phone
(601) 362-6888
Fax
(601) 362-7744
NPI assigned
May 23, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2014

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

Authorized official

Name
Pam McLeod
Title
Owner
Phone
(601) 362-6888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Compounding Pharmacy 3336C0004X 04095/1.1 MS Primary

Addresses

Primary practice location

1000 Lakeland Square Ext
Suite 100
Flowood, MS 39232-7620

Mailing address

1000 Lakeland Square Ext
Suite 100
Flowood, MS 39232-7620
Phone (601) 362-6888

Other identifiers 1

IdentifierTypeStateIssuer
2519215OtherMSNABP

National Provider Directory

National Provider Directory

Locations

1000 Lakeland Square Ext
Ste 100
Flowood, MS 39232
Phone (601) 362-6888

NPI Registry JSON

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

{
    "created_epoch": "1400803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401235200000",
    "number": "1295147346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 LAKELAND SQUARE EXT",
            "address_2": "SUITE 100",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327620",
            "telephone_number": "601-362-6888",
            "fax_number": "601-362-7744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 LAKELAND SQUARE EXT",
            "address_2": "SUITE 100",
            "city": "FLOWOOD",
            "state": "MS",
            "postal_code": "392327620",
            "telephone_number": "601-362-6888",
            "fax_number": "601-362-7744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALTY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-23",
        "last_updated": "2014-05-28",
        "status": "A",
        "authorized_official_last_name": "MCLEOD",
        "authorized_official_first_name": "PAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-362-6888"
    },
    "taxonomies": [
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": "MS",
            "license": "04095/1.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP",
            "identifier": "2519215",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flowood, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2014; 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.