Organization Active NPI

Chris Pharmacy LLC

  • Community/Retail Pharmacy
  • Columbus, MS
National Provider Identifier
1487901419
Registry record updated May 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
11547/1.1 Issued in MS
Legal business name
CHRIS PHARMACY LLC
Practice address
2320 5TH St N
Columbus, MS 39705-2214
Phone
(662) 328-4300
Fax
(662) 328-4306
NPI assigned
Aug 9, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 18, 2016

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

Authorized official

Name
Chris Bonner
Title
Owner/Pharnacist
Phone
(662) 242-2567

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 11547/1.1 MS Primary

Addresses

Primary practice location

2320 5TH St N
Columbus, MS 39705-2214

Mailing address

2320 5TH St N
Columbus, MS 39705-2214
Phone (662) 328-4300

Other identifiers 2

IdentifierTypeStateIssuer
01279241MedicaidMS
2136424OtherPK

Other names 1

  • Chris' Pharmacy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201111000848 MS Part B Supplier - Pharmacy 8426468034 Practice locations: Columbus, MS

National Provider Directory

National Provider Directory

Locations

2320 5th St N
Columbus, MS 39705
Phone (662) 328-4300

Practitioners & affiliated clinicians

Practitioners 1

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": "1344470400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463529600000",
    "number": "1487901419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2320 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052214",
            "telephone_number": "662-328-4300",
            "fax_number": "662-328-4306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2320 5TH ST N",
            "city": "COLUMBUS",
            "state": "MS",
            "postal_code": "397052214",
            "telephone_number": "662-328-4300",
            "fax_number": "662-328-4306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHRIS PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-08-09",
        "last_updated": "2016-05-18",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "CHRIS",
        "authorized_official_title_or_position": "OWNER/PHARNACIST",
        "authorized_official_telephone_number": "662-242-2567"
    },
    "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": "11547/1.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01279241",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2136424",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chris' Pharmacy",
            "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 May 18, 2016; 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.