NPIMap

Organization Active NPI

Controlex Enterprises, Inc.

Doing business as Vancleave Sav-Rex #637

  • Pharmacy
  • Vancleave, MS
National Provider Identifier
1376620898
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
01145/01.2 Issued in MS
Legal business name
CONTROLEX ENTERPRISES, INC.
Doing business as
Vancleave Sav-Rex #637
Practice address
11936 Highway 57
Vancleave, MS 39565-8298
Phone
(228) 826-4403
Fax
(228) 826-5165
NPI assigned
Nov 1, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Ms. Modena S Cannon
Title
Pharmacy Operations Manager
Phone
(228) 769-7067

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X 01145/01.2 MS Primary

Addresses

Primary practice location

11936 Highway 57
Vancleave, MS 39565-8298

Mailing address

1420 Ingalls Ave
Pascagoula, MS 39567-5650
Phone (228) 769-7067

Other identifiers 2

IdentifierTypeStateIssuer
00330424MedicaidMS
2510560OtherMSNCPDP

Other names 1

  • VANCLEAVE SAV-REX #637 Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Controlex Enterprises Inc4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

11936 Highway 57
Vancleave, MS 39565
Phone (228) 826-4403

NPI Registry JSON

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

{
    "created_epoch": "1162339200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1376620898",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 INGALLS AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395675650",
            "telephone_number": "228-769-7067",
            "fax_number": "228-762-1756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11936 HIGHWAY 57",
            "city": "VANCLEAVE",
            "state": "MS",
            "postal_code": "395658298",
            "telephone_number": "228-826-4403",
            "fax_number": "228-826-5165"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTROLEX ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-01",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "MODENA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHARMACY OPERATIONS MANAGER",
        "authorized_official_telephone_number": "228-769-7067",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "01145/01.2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330424",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2510560",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "VANCLEAVE SAV-REX #637",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vancleave, MS

Sources for this page

  • 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.