Rolling Fork Drug Co

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

ROLLING FORK DRUG CO

Practice address

20917 Highway 61
Rolling Fork, MS 39159-5027

Phone

(662) 873-4723

Fax

(662) 873-4002

NPI assigned

Aug 23, 2019

Last updated

Dec 19, 2019By 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

Guy M Phillips, RPH.NPI 1922187327

Title

Owner/President

Phone

(662) 207-0616

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Tax ID family

Rolling Fork Drug Co2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Rolling Fork Drug Co

  dba Rolling Fork Drug Company LTC

  • Long Term Care Pharmacy
  • Rolling Fork, MS
  • NPI 1356153688
  NPD tax ID

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Guy M Phillips

  • Pharmacist
  • Indianola, MS
  • NPI 1922187327
  Authorized official Same address or phone

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1576713600000",
    "number": "1508413592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "903 HIGHWAY 82 E BLDG G",
            "city": "INDIANOLA",
            "state": "MS",
            "postal_code": "387512325",
            "telephone_number": "662-887-4135",
            "fax_number": "662-887-9703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20917 HIGHWAY 61",
            "city": "ROLLING FORK",
            "state": "MS",
            "postal_code": "391595027",
            "telephone_number": "662-873-4723",
            "fax_number": "662-873-4002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ROLLING FORK DRUG CO",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-08-23",
        "last_updated": "2019-12-19",
        "certification_date": "2019-12-19",
        "status": "A",
        "authorized_official_last_name": "PHILLIPS",
        "authorized_official_first_name": "GUY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "662-207-0616",
        "authorized_official_credential": "RPH."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pain Treatment Centers of America, PLLC (Family Care Centers of America)
• Allen Brantley Pearson, FNP-C
• Casey Cummins Perry, PHARM. D.
• RCG of Mayersville, LLC
• Rolling Fork Drug Co (Rolling Fork Drug Company LTC)
• Rolling Fork Eye Clinic
• Rolling Fork Medical Clinic, LLC
• Sharkey Issaquena Comm Hosp - Ekg
• Sharkey Issaquena Comm Hosp-Ambulance
• Sharkey Issaquena Comm Hosp-ER

• Community/Retail Pharmacy in Rolling Fork, MS
• Providers in Rolling Fork, 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 Dec 19, 2019; 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.