Organization Active NPI

Mississippi Senior Care

  • Long Term Care Pharmacy
  • Tupelo, MS
National Provider Identifier
1497133391
Registry record updated Jul 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
Legal business name
MISSISSIPPI SENIOR CARE
Practice address
86 S Thomas St
Tupelo, MS 38801-4355
Phone
(662) 844-0400
Fax
(662) 844-5605
NPI assigned
May 11, 2015
Last updated
Jul 28, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2021

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

Authorized official

Name
Mr. James Marc Gunnells, R.PH
Title
President
Phone
(662) 678-3330

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Long Term Care Pharmacy 3336L0003X Primary

Addresses

Primary practice location

86 S Thomas St
Tupelo, MS 38801-4355

Mailing address

86 S Thomas St
Tupelo, MS 38801-4355
Phone (662) 844-0400

Other identifiers 1

IdentifierTypeStateIssuer
1382603MedicaidMS

National Provider Directory

National Provider Directory

Locations

86 S Thomas St
Tupelo, MS 38801
Phone (662) 678-3330

NPI Registry JSON

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

{
    "created_epoch": "1431302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1627430400000",
    "number": "1497133391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 S THOMAS ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014355",
            "telephone_number": "662-844-0400",
            "fax_number": "662-844-5605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 S THOMAS ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388014355",
            "telephone_number": "662-844-0400",
            "fax_number": "662-844-5605"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI SENIOR CARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-05-11",
        "last_updated": "2021-07-28",
        "certification_date": "2021-03-29",
        "status": "A",
        "authorized_official_last_name": "GUNNELLS",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "MARC",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "662-678-3330",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH"
    },
    "taxonomies": [
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1382603",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tupelo, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2021; 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.