NPIMap

Organization Active NPI

Duncan's Pharmacy, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Walnut, MS
National Provider Identifier
1316063159
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
01789-01.1 Issued in MS
Legal business name
DUNCAN'S PHARMACY, INC.
Practice address
28271 Highway 15
Walnut, MS 38683-8930
Phone
(662) 223-4727
Fax
(662) 223-5899
NPI assigned
Mar 22, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Jim D Jackson, R.PH.
Title
Owner & President
Phone
(662) 223-4727

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 01789-01.1 MS Primary

Addresses

Primary practice location

28271 Highway 15
Walnut, MS 38683-8930

Mailing address

28271 Highway 15
Walnut, MS 38683-8930
Phone (662) 223-4727

Other identifiers 1

IdentifierTypeStateIssuer
00040322OtherMSMS MEDICAID DME #

Medicare participation

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

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20100930014031 MS DME Supplier - Pharmacy 7315065729 Practice locations: Walnut, MS
O20140827001360 MS Part B Supplier - Mass Immunization (Roster Biller Only) 7315065729 Practice locations: Walnut, MS

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Duncan's Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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": "1174521600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1316063159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28271 HIGHWAY 15",
            "city": "WALNUT",
            "state": "MS",
            "postal_code": "386838930",
            "telephone_number": "662-223-4727",
            "fax_number": "662-223-5899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28271 HIGHWAY 15",
            "city": "WALNUT",
            "state": "MS",
            "postal_code": "386838930",
            "telephone_number": "662-223-4727",
            "fax_number": "662-223-5899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DUNCAN'S PHARMACY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-22",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "JIM",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "OWNER  &  PRESIDENT",
        "authorized_official_telephone_number": "662-223-4727",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "01789-01.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MS MEDICAID DME #",
            "identifier": "00040322",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Walnut, MS

Sources for this page

  • 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.
  • 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.