Medical Plaza on Alcorn LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0313501.1 Issued in MS

Legal business name

MEDICAL PLAZA ON ALCORN LLC

Practice address

111 Alcorn Dr
Corinth, MS 38834-9359

Phone

(662) 286-6991

Fax

(662) 287-8087

NPI assigned

Sep 20, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Rick W Quinn

Title

RPH

Phone

(662) 286-6991

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441065600000",
    "number": "1497852602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349359",
            "telephone_number": "662-286-6991",
            "fax_number": "662-287-8087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ALCORN DR",
            "city": "CORINTH",
            "state": "MS",
            "postal_code": "388349359",
            "telephone_number": "662-286-6991",
            "fax_number": "662-287-8087"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL PLAZA ON ALCORN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2015-09-01",
        "status": "A",
        "authorized_official_last_name": "QUINN",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "RPH",
        "authorized_official_telephone_number": "662-286-6991",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "0313501.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00440678",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00095265",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michael McNair, CRNA
• Marvin E McQueen, DDS
• Med Supply Center, Inc
• Med Supply Plus, Inc.
• Med Supply Plus, Inc.
• Medical Plaza on Alcorn LLC
• Medical Plaza on Harper LLC
• Medical Plaza Pharmacy
• Medisend Specialty Pharmacy Inc
• Meds on Alcorn, LLC

• Community/Retail Pharmacy in Corinth, MS
• Providers in Corinth, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2015; 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.