NPIMap

Organization Active NPI

Tunica Pharmacy, Inc.

  • Community/Retail Pharmacy
  • Tunica, MS
National Provider Identifier
1316037237
Registry record updated Oct 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
00653 Issued in MS
Legal business name
TUNICA PHARMACY, INC.
Practice address
1337 Highway 61 N
Tunica, MS 38676-9661
Phone
(662) 363-1431
Fax
(662) 363-9966
NPI assigned
Oct 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2023

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

Authorized official

Name
William Eric Poff, R.PH.NPI 1740720739
Title
Owner President
Phone
(901) 826-6493

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 00653 MS Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1337 Highway 61 N
Tunica, MS 38676-9661

Mailing address

PO Box 1724
Tunica, MS 38676-1724
Phone (662) 363-1431

Other identifiers 3

IdentifierTypeStateIssuer
2043432OtherPK
00034711MedicaidMS
000034711MedicaidMS

Other names 1

  • TUNICA PHARMACY Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20181004000210 MS Part B Supplier - Mass Immunization (Roster Biller Only) 7315299237 Practice locations: Tunica, MS
O20240315002813 MS Part B Supplier - Independent Clinical Laboratory 7315299237 Practice locations: Tunica, MS

National Provider Directory

National Provider Directory

Locations

1337 Highway 61 N
Tunica, MS 38676
Phone (662) 363-1431

1181 Main St
Tunica, MS 38676
Phone (662) 363-1431

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697414400000",
    "number": "1316037237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1724",
            "city": "TUNICA",
            "state": "MS",
            "postal_code": "386761724",
            "telephone_number": "662-363-1431",
            "fax_number": "663-363-9966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1337 HIGHWAY 61 N",
            "city": "TUNICA",
            "state": "MS",
            "postal_code": "386769661",
            "telephone_number": "662-363-1431",
            "fax_number": "662-363-9966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TUNICA PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2023-10-16",
        "certification_date": "2023-10-16",
        "status": "A",
        "authorized_official_last_name": "POFF",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_middle_name": "ERIC",
        "authorized_official_title_or_position": "OWNER PRESIDENT",
        "authorized_official_telephone_number": "901-826-6493",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00653",
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2043432",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00034711",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000034711",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "TUNICA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "TUNICA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Tunica, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.