Griffin's Discount Pharmacy Inc

Primary specialty

PharmacyTaxonomy code 333600000X

License

01477 Issued in MS

Legal business name

GRIFFIN'S DISCOUNT PHARMACY INC

Practice address

339 E Madison St
Houston, MS 38851-2322

Phone

(662) 456-2501

Fax

(662) 456-4052

NPI assigned

Oct 4, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Ken R Fullilove Jr.

Title

Co-Owner

Phone

(662) 456-2501

Specialties & licenses 1

Addresses

Other identifiers 3

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1346336757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 E MADISON ST",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388512322",
            "telephone_number": "662-456-2501",
            "fax_number": "662-456-4052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 E MADISON ST",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388512322",
            "telephone_number": "662-456-2501",
            "fax_number": "662-456-4052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GRIFFIN'S DISCOUNT PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "FULLILOVE",
        "authorized_official_first_name": "KEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CO-OWNER",
        "authorized_official_telephone_number": "662-456-2501",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Jr."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "01477",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030446",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2511954",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACY PERMIT",
            "identifier": "01477",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bethany Anna Free, FNP- BC
• Angela Furr, C.F.N.P.
• Katie Melia Gann, CFNP
• Noel Villarosa Garcia, M.D.
• Edward Kirkham Gore, MD
• Regina Lynn Grimes, PT, C/NDT, ATP
• Morrisa Shettles Hancock, CCC-SLP
• Mary Kate Harmon, SLP
• Harris Family Clinic LLC (Harris Family Clinic)
• Aretha Renee Harris, FNP-C

• Pharmacy in Houston, MS
• Providers in Houston, MS by specialty
• Pharmacy in Mississippi

• 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.