Gillis Drugstore

Primary specialty

PharmacyTaxonomy code 333600000X

License

00972 Issued in MS

Legal business name

GILLIS DRUGSTORE

Practice address

219 State Street
McComb, MS 39648

Phone

(601) 684-2621

Fax

(601) 684-2622

NPI assigned

Aug 4, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Tom E Assaf, RPH

Title

Pharmacist

Phone

(601) 684-2621

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1154649600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1316955362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 STATE STREET",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "39648",
            "telephone_number": "601-684-2621",
            "fax_number": "601-684-2622"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "219 STATE STREET",
            "city": "MCCOMB",
            "state": "MS",
            "postal_code": "39648",
            "telephone_number": "601-684-2621",
            "fax_number": "601-684-2622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GILLIS DRUGSTORE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-04",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "ASSAF",
        "authorized_official_first_name": "TOM",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "601-684-2621",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "00972",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030161",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF PHARMACY PERMIT",
            "identifier": "00972",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristy Gates
• Coeva Barnes Gatlin, FNP-BC
• General Vascular Surgery Specialist P a
• Melvin George
• Josie Gibson
• Gillis Express Inc
• Kathryn Ginn
• Christopher Clayton Givens, NURSE PRACTIONER
• Tera Elizabeth Givens, CNM
• Cynthia Louise Glasson, D.O.

• All providers in McComb, MS
• Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.