Mississippi Pharmaceutical Services, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

MISSISSIPPI PHARMACEUTICAL SERVICES, LLC

Doing business as

Columbia Medical Supply

Practice address

807 Highway 98 Byp
Columbia, MS 39429-3710

Phone

(601) 736-0843

Fax

(601) 736-0845

NPI assigned

Nov 1, 2005

Organization subpart

No

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

Authorized official

Name

Mrs. Kim A Patterson, RN

Title

Owner/President

Phone

(601) 736-0843

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• COLUMBIA MEDICAL SUPPLY Doing business as

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1130803200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672099200000",
    "number": "1356332183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "807 HIGHWAY 98 BYP",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293710",
            "telephone_number": "601-736-0843",
            "fax_number": "601-736-0845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "807 HIGHWAY 98 BYP",
            "city": "COLUMBIA",
            "state": "MS",
            "postal_code": "394293710",
            "telephone_number": "601-736-0843",
            "fax_number": "601-736-0845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI PHARMACEUTICAL SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-11-01",
        "last_updated": "2022-12-27",
        "certification_date": "2022-12-27",
        "status": "A",
        "authorized_official_last_name": "PATTERSON",
        "authorized_official_first_name": "KIM",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "601-736-0843",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MS",
            "license": "05055/11.1",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00440782",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "COLUMBIA MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "COLUMBIA MEDICAL SUPPLY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shelley McKenzie, LMSW
• Susan Lorenda McLendon, LPN
• Med360 LLC (Med360)
• Larry Ethan Milton, DPM
• Janet Mingo
• Mississippi State Department of Health
• Jennifer Moak
• Lillian Grace Monroe
• Moore Family Dental, PLLC (Columbia Family Dental)
• Ethan Embrey Moore, DMD

• Durable Medical Equipment & Medical Supplies in Columbia, MS
• Providers in Columbia, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.