Enterprise Pharmacy LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

0843211 Issued in MS

Legal business name

ENTERPRISE PHARMACY LLC

Doing business as

Enterprise Pharmacy

Practice address

83 Old Mill Creek Rd
Enterprise, MS 39330-9649

Phone

(601) 659-9909

Fax

(601) 659-9902

NPI assigned

Apr 5, 2010

Last updated

Jul 5, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Daniel Johnson

Title

Owner

Phone

(601) 938-5323

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Enterprise Pharmacy Doing business as

Locations

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

{
    "created_epoch": "1270425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1467676800000",
    "number": "1447575394",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "83 OLD MILL CREEK RD",
            "city": "ENTERPRISE",
            "state": "MS",
            "postal_code": "393309649",
            "telephone_number": "601-659-9909",
            "fax_number": "601-659-9902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 OLD MILL CREEK RD",
            "city": "ENTERPRISE",
            "state": "MS",
            "postal_code": "393309649",
            "telephone_number": "601-659-9909",
            "fax_number": "601-659-9902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENTERPRISE PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-04-05",
        "last_updated": "2016-07-05",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-938-5323"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "0843211",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00258810",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2127578",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enterprise Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Pharmacy in Enterprise, MS
• Providers in Enterprise, MS by specialty
• Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 5, 2016; 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.