NPIMap

Organization Active NPI

Ms State Dept of Health

  • Long Term Care Pharmacy
  • Jackson, MS
National Provider Identifier
1376606582
Registry record updated Oct 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MS STATE DEPT OF HEALTH
Practice address
3156 Lawson Street
Jackson, MS 39213
Phone
(601) 713-3457
Fax
(601) 364-2670
NPI assigned
Dec 18, 2006
Last updated
Oct 22, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2024

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

Authorized official

Name
Julia Woods
Title
Pharmacist
Phone
(601) 713-3457

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Public Health or Welfare Agency 251K00000X 01085 05.1 MS
Clinic Pharmacy 3336C0002X 0108505.1 MS
Long Term Care Pharmacy 3336L0003X NU Primary

Addresses

Primary practice location

3156 Lawson Street
Jackson, MS 39213

Mailing address

3156 Lawson Street
Jackson, MS 39213
Phone (601) 713-3457

Other identifiers 1

IdentifierTypeStateIssuer
2517196OtherNCPDP

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20241212003423 MS Part B Supplier - Pharmacy 0244129245 Practice locations: Jackson, MS

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Mississippi Department Health126 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations (25 of 60)

1300 Highway 125 S
Amory, MS 38821
Phone (662) 256-5341

105 4th St
Ashland, MS 38603
Phone (662) 224-6442

327 Highway 51 N
Ste 5
Batesville, MS 38606
Phone (662) 563-9334

381 Highway 51 S
Batesville, MS 38606
Phone (662) 563-4616

3062 Longfellow Rd
Bay Saint Louis, MS 39520
Phone (228) 467-4510

2761 Highway 15
Bay Springs, MS 39422
Phone (601) 764-2419

856 Highway 90
Bay St Louis, MS 39520
Phone (228) 467-4510

107 S Hayden St
Belzoni, MS 39038
Phone (662) 247-1861

515 E Church St
Booneville, MS 38829
Phone (662) 844-2020

615 E Parker Dr
Booneville, MS 38829
Phone (662) 728-3518

317 N Union St
Canton, MS 39046
Phone (601) 859-3316

300 C O Brooks St
Carthage, MS 39051
Phone (601) 267-3280

908 Sumrall Rd
Columbia, MS 39429
Phone (601) 736-2676

1112 Military Rd
Columbus, MS 39701
Phone (662) 328-6091

400A Wilkins Wise Rd
Ste 1
Columbus, MS 39705
Phone (662) 328-6158

5166 Hwy 11 N
Jones County Health Dept
Ellisville, MS 39437
Phone (601) 426-3258

5168 Highway 11 N
Ellisville, MS 39437
Phone (601) 426-3258

57 Government Ave
Eupora, MS 39744
Phone (662) 258-3761

519 Airport Rd
Forest, MS 39074
Phone (601) 469-4941

313 Arnold Ave
Greenville, MS 38701
Phone (662) 332-1398

1240 Fairground Rd
Ste A
Grenada, MS 38901
Phone (662) 226-3711

5008 Old Highway 42
Hattiesburg, MS 39401
Phone (601) 583-0291

3212 Highway 51 S
#A
Hernando, MS 38632
Phone (662) 429-9814

112 W Washington St
Hollandale, MS 38748
Phone (662) 807-5007

332 N Jefferson St
Houston, MS 38851
Phone (662) 456-3737

Practitioners & affiliated clinicians

Practitioners 57

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.

View all 57

NPI Registry JSON

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

{
    "created_epoch": "1166400000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1729555200000",
    "number": "1376606582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3156 LAWSON STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-713-3457",
            "fax_number": "601-364-2670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3156 LAWSON STREET",
            "city": "JACKSON",
            "state": "MS",
            "postal_code": "39213",
            "telephone_number": "601-713-3457",
            "fax_number": "601-364-2670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MS STATE DEPT OF HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-18",
        "last_updated": "2024-10-22",
        "certification_date": "2024-10-22",
        "status": "A",
        "authorized_official_last_name": "WOODS",
        "authorized_official_first_name": "JULIA",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "601-713-3457"
    },
    "taxonomies": [
        {
            "code": "251K00000X",
            "taxonomy_group": "",
            "desc": "Public Health or Welfare",
            "state": "MS",
            "license": "01085 05.1",
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MS",
            "license": "0108505.1",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2517196",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.