Mill Street Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

111177 Issued in AL

Legal business name

MILL STREET PHARMACY INC

Practice address

10639 Al Highway 168
Boaz, AL 35957-1955

Phone

(256) 593-5279

Fax

(256) 593-1991

NPI assigned

Sep 1, 2006

Organization subpart

No

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

Authorized official

Name

Patrick PhillipsNPI 1982094736

Title

Owner

Phone

(256) 593-5279

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Mill Street Pharmacy Inc Doing business as

Medicare fee-for-service enrollment

Enrolled in AL

Enrollment records 1

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

Locations

Practitioners 2

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

• Patrick Phillips, PHARMD

  • Pharmacist
  • Boaz, AL
  • NPI 1982094736
  NPD Authorized official
• Jeffrey Clay Roberts, RPH

  • Pharmacist
  • Boaz, AL
  • NPI 1629140652
  NPD (past)

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

{
    "created_epoch": "1157068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487721600000",
    "number": "1295837300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10639 AL HIGHWAY 168",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359571955",
            "telephone_number": "256-593-5279",
            "fax_number": "256-593-1991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10639 AL HIGHWAY 168",
            "city": "BOAZ",
            "state": "AL",
            "postal_code": "359571955",
            "telephone_number": "256-593-5279",
            "fax_number": "256-593-1991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILL STREET PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-01",
        "last_updated": "2017-02-22",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "256-593-5279"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AL",
            "license": "111177",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "169336",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2150239",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mill Street Pharmacy Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Boaz, AL
• Providers in Boaz, AL by specialty
• Community/Retail Pharmacy in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; 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.