Active NPI
Nathan Robert Alexander Allen, RPH
- Pharmacist
- Southaven, MS
National Provider Identifier
1336812700
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E-100286
- Practice address
- 2996 Church Rd E
Southaven, MS 38671-9825 - Phone
- (662) 349-4418
- NPI assigned
- Jul 30, 2021
- Last updated
- Jul 30, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E-100286 | MS | Primary |
Addresses
Primary practice location
2996 Church Rd E
Southaven, MS 38671-9825
Mailing address
9129 Lakeshore Dr
Olive Branch, MS 38654-1532
Phone (662) 671-9551
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-100286 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Current | Accepting new patients | |
| Walgreen Co | Past | Accepting new patients |
Locations
2996 Church Rd E
Southaven, MS 38671
Phone (662) 349-4418
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1627603200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627603200000",
"number": "1336812700",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9129 LAKESHORE DR",
"city": "OLIVE BRANCH",
"state": "MS",
"postal_code": "386541532",
"telephone_number": "662-671-9551"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2996 CHURCH RD E",
"city": "SOUTHAVEN",
"state": "MS",
"postal_code": "386719825",
"telephone_number": "662-349-4418"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ALLEN",
"first_name": "NATHAN",
"middle_name": "ROBERT ALEXANDER",
"name_prefix": "Dr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-30",
"last_updated": "2021-07-30",
"certification_date": "2021-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E-100286",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Southaven, MS
- Roy A. Alinsub, PT
- Ashley Allen
- Deterrence Deon Allen, M.S., BCBA, LBA
- Eric W Allen, LPC
- Lakendra NE'Shay Allen, FNP
- Alliance Health Services Inc (Alliance Home Care Services)
- Alliance Health Services, Inc (Alliance Hospice - Mississippi)
- Alliance Home Care Agency LLC
- Allstar Transport Services, LLC
- Johnanna D Almand
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.