Active NPI
Kenneth E Prewett, RPH
- Pharmacist
- Pontotoc, MS
National Provider Identifier
1376852525
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- E5820
- Practice address
- 170 Highway 15 N
Pontotoc, MS 38863 - Phone
- (662) 489-4721
- Fax
- (662) 489-0335
- NPI assigned
- Oct 5, 2010
- Last updated
- Oct 5, 2010
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | E5820 | MS | Primary |
Addresses
Primary practice location
170 Highway 15 N
Pontotoc, MS 38863
Mailing address
P. O. Box 824
Pontotoc, MS 38863
Phone (662) 489-4721
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E5820 | MS | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Freds Stores of Tennessee Inc | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Freds Pharmacy 3648
- Community/Retail Pharmacy
- Greenville, MS
- NPI 1093969016
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1286236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1286236800000",
"number": "1376852525",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "P. O. BOX 824",
"city": "PONTOTOC",
"state": "MS",
"postal_code": "38863",
"telephone_number": "662-489-4721",
"fax_number": "662-489-0335"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "170 HIGHWAY 15 N",
"city": "PONTOTOC",
"state": "MS",
"postal_code": "38863",
"telephone_number": "662-489-4721",
"fax_number": "662-489-0335"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PREWETT",
"first_name": "KENNETH",
"middle_name": "E",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2010-10-05",
"last_updated": "2010-10-05",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MS",
"license": "E5820",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pontotoc, MS
- Pontotoc Health Services, Inc. (Pontotoc Hospital Ambulance)
- Pontotoc Health Services, Inc. (Pontotoc Health Services CAH)
- Pontotoc Health Services, Inc. (Pontotoc Health Services CAH - Swing Bed)
- Pontotoc LTC, Inc (Pontotoc Health & Rehab Center)
- Pototoc Health Services Inc (Pontotoc hospital Pharmacy)
- PT Mobile, LLC
- Keri Connelly Purser
- R&B Dental Group Inc (One Smile Dental Group)
- Redmed, LLC
- Redmed, LLC (RedMed)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.