Active NPI
Magic Mart Pharmacy,Inc
Doing business as Magic Mart Pharmacy LTC
- Long Term Care Pharmacy
- Indianola, MS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- MAGIC MART PHARMACY,INC
- Doing business as
- Magic Mart Pharmacy LTC
- Practice address
- 903 Highway 82 E BLDG G
Indianola, MS 38751-2325 - Phone
- (662) 887-4135
- Fax
- (662) 887-9703
- NPI assigned
- Apr 23, 2024
- Last updated
- Apr 23, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Guy M Phillips
- Title
- President/Owner
- Phone
- (662) 887-4135
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
903 Highway 82 E BLDG G
Indianola, MS 38751-2325
Mailing address
903 Highway 82 E BLDG G
Indianola, MS 38751-2325
Phone (662) 887-4135
Other names 1
- Magic Mart Pharmacy LTC
National Provider Directory
National Provider Directory- Tax ID family
- Magic Mart Pharmacy DS
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Magic Mart Pharmacy, DS
- Mail Order Pharmacy
- Indianola, MS
- NPI 1164268686
Locations
903 Highway 82 E
#G
Indianola, MS 38751
Phone (662) 887-1435
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Pharmacist
- Indianola, MS
- NPI 1922187327
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713830400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1713830400000",
"number": "1356196273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "903 HIGHWAY 82 E BLDG G",
"city": "INDIANOLA",
"state": "MS",
"postal_code": "387512325",
"telephone_number": "662-887-4135",
"fax_number": "662-887-9703"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "903 HIGHWAY 82 E BLDG G",
"city": "INDIANOLA",
"state": "MS",
"postal_code": "387512325",
"telephone_number": "662-887-4135",
"fax_number": "662-887-9703"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MAGIC MART PHARMACY,INC",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-23",
"last_updated": "2024-04-23",
"certification_date": "2024-04-23",
"status": "A",
"authorized_official_last_name": "PHILLIPS",
"authorized_official_first_name": "GUY",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "PRESIDENT/OWNER",
"authorized_official_telephone_number": "662-887-4135"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Magic Mart Pharmacy LTC",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Indianola, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.