Oak Grove Pharmacy

Primary specialty

PharmacistTaxonomy code 183500000X

License

07555 Issued in MS

Legal business name

OAK GROVE PHARMACY

Practice address

5039 Old Highway 11
Suite# 1
Hattiesburg, MS 39402-8845

Phone

(601) 264-1198

Fax

(601) 264-1106

NPI assigned

Nov 14, 2006

Last updated

Aug 22, 2020By 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

Mr. John Stephens

Title

Pharmacist

Phone

(601) 264-1198

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1163462400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477625705",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5039 OLD HIGHWAY 11",
            "address_2": "SUITE# 1",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028845",
            "telephone_number": "601-264-1198",
            "fax_number": "601-264-1106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5039 OLD HIGHWAY 11",
            "address_2": "SUITE# 1",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394028845",
            "telephone_number": "601-264-1198",
            "fax_number": "601-264-1106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OAK GROVE PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-14",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "601-264-1198",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "07555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030315",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Oak Grove Family Clinic
• Oak Grove Family Dentistry
• Oak Grove High School
• Oak Grove Longleaf
• Oak Grove Middle School
• OB-GYN Group of Hattiesburg, LLC
• Gregory Obert, PH.D., LCPC
• Mariana Ocampo
• Ochsner Clinic LLC (Ochsner - Pediatric Cardiology Hattiesburg)
• Ochsner Mississippi, LLC (Ochsner Pediatric Plastic Surgery)

• Pharmacist in Hattiesburg, MS
• Providers in Hattiesburg, MS by specialty
• Pharmacist in Mississippi

• 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.