Chadwick Cabanero, PHARMD
Individual provider Active NPI Community/Retail Pharmacy · Clinton, MS
NPI 1487400677 · NPPES record last updated Apr 29, 2024
Key facts
- NPI
- 1487400677
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Community/Retail Pharmacy 3336C0003X
- License
- E-101454 (MS)
- Practice address
- 204 Highway 80 E
Clinton, MS 39056-4716 - Phone
- (601) 926-1179
- NPI assigned
- Apr 29, 2024
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E-101454 | MS | MD | Community/Retail Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Community/Retail Pharmacy | Current |
Accepting new patients |
| Walgreen Co | Community/Retail Pharmacy | Past |
Accepting new patients |
Locations
204 Highway 80 E
Clinton, MS 39056
Phone (601) 926-1116
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | E-101454 | MS | Yes |
Addresses
Primary practice location
204 Highway 80 E
Clinton, MS 39056-4716
Mailing address
866 Cypress Pond Dr
Collierville, TN 38017-2165
Other providers in Clinton, MS
- Sheila Marie Butler
- Yvette Fortner Butler
- Emma Claire Byers
- Taylor M Byrd
- William Hudson Byrnes
- Cac Therapy Group, LLC
- Catherine E. Callender
- Tara Cameron
- William Michael Campbell
- Fulivia Elma Cannady
All providers in Clinton, MS · Community/Retail Pharmacy in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.