NPIMap

Organization Active NPI

SLC Holdings

  • Community/Retail Pharmacy
  • Columbus, MS
National Provider Identifier
1386729317
Registry record updated Dec 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
01383/1.1 Issued in MS
Legal business name
SLC HOLDINGS
Doing business as
Robert's Apothecary
Practice address
2219 5TH St N
Columbus, MS 39705-2211
Phone
(662) 327-5400
Fax
(662) 327-5225
NPI assigned
Oct 26, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2020

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

Authorized official

Name
Jene' LandrumNPI 1053980912
Title
Manager
Phone
(662) 327-5400

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 01383/1.1 MS Primary
Compounding Pharmacy 3336C0004X

Addresses

Primary practice location

2219 5TH St N
Columbus, MS 39705-2211

Mailing address

2219 5TH St N
Columbus, MS 39705-2211
Phone (662) 327-5400

Other identifiers 3

IdentifierTypeStateIssuer
0030014MedicaidMS
2144373OtherPK
00040353MedicaidMS

Other names 1

  • Robert's Apothecary Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201106002164 MS Part B Supplier - Mass Immunization (Roster Biller Only) 2961812698 Practice locations: Columbus, MS

National Provider Directory

National Provider Directory
Tax ID family
SLC Holdings2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161820800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608595200000",
    "number": "1386729317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2219 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052211",
            "telephone_number": "662-327-5400",
            "fax_number": "662-327-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2219 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052211",
            "telephone_number": "662-327-5400",
            "fax_number": "662-327-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SLC HOLDINGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-26",
        "last_updated": "2020-12-22",
        "certification_date": "2020-12-22",
        "status": "A",
        "authorized_official_last_name": "LANDRUM",
        "authorized_official_first_name": "JENE'",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-327-5400"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "01383/1.1",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0030014",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2144373",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00040353",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Robert's Apothecary",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Columbus, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2020; 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.