Organization Active NPI

Colonial Discount Drugs

  • Pharmacist
  • Vicksburg, MS
National Provider Identifier
1467485839
Registry record updated Dec 14, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
E7063 Issued in MS
Legal business name
COLONIAL DISCOUNT DRUGS
Practice address
1017 Mission 66
Vicksburg, MS 39183-2753
Phone
(601) 638-5521
Fax
(601) 638-5522
NPI assigned
Jul 9, 2006
Last updated
Dec 14, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 14, 2010

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

Authorized official

Name
Mr. J. Richard Thomas, R. PH.NPI 1538250378
Title
Phamacist/Manager
Phone
(601) 638-5521

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X E7063 MS Primary

Addresses

Primary practice location

1017 Mission 66
Vicksburg, MS 39183-2753

Mailing address

1017 Mission 66
Vicksburg, MS 39183-2753
Phone (601) 638-5521

Other identifiers 2

IdentifierTypeStateIssuer
2507587OtherMSNABP/NCPDP
00030232MedicaidMS

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1152403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1292284800000",
    "number": "1467485839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1017 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832753",
            "telephone_number": "601-638-5521",
            "fax_number": "601-638-5522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1017 MISSION 66",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391832753",
            "telephone_number": "601-638-5521",
            "fax_number": "601-638-5522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLONIAL DISCOUNT DRUGS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-09",
        "last_updated": "2010-12-14",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "J.",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PHAMACIST/MANAGER",
        "authorized_official_telephone_number": "601-638-5521",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R. PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "E7063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NABP/NCPDP",
            "identifier": "2507587",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030232",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 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.

Verify at the official NPI Registry.