Senatobia City Drug Co Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00121011 Issued in MS

Legal business name

SENATOBIA CITY DRUG CO INC

Practice address

122 Norfleet Dr
Senatobia, MS 38668-2220

Phone

(662) 562-8042

Fax

(662) 562-0644

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

Lynn Barham, RPH

Title

Owner

Phone

(662) 562-8042

Specialties & licenses 4

Addresses

Other identifiers 3

Other names 1

• Senatobia City Drug Co Inc Doing business as

Tax ID family

Senatobia City Drug2 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.

• Senatobia City Drug

  • Durable Medical Equipment & Medical Supplies
  • Senatobia, MS
  • NPI 1114051042
  NPD tax ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Darroth Leonard Barham, RPH

  • Pharmacist
  • Senatobia, MS
  • NPI 1215027313
  NPD (past)
• Dawn M Simpson, RPH

  • Pharmacist
  • Senatobia, MS
  • NPI 1255421350
  NPD (past)

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227225600000",
    "number": "1508963430",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 NORFLEET DR",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "122 NORFLEET DR",
            "city": "SENATOBIA",
            "state": "MS",
            "postal_code": "386682220",
            "telephone_number": "662-562-8042",
            "fax_number": "662-562-0644"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENATOBIA CITY DRUG CO INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-11-21",
        "status": "A",
        "authorized_official_last_name": "BARHAM",
        "authorized_official_first_name": "LYNN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-562-8042",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00121011",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030821",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00440236",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2507056",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Senatobia City Drug Co Inc",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Forster Gehring Ruhl Jr., MD
• Sawyer Scott Eyecare Center PLLC
• SCCR,LLC
• Samuel Sawyer Scott, OD
• Senatobia City Drug
• Senatobia Dental Care, P.C.
• Senatobia Dental Studio PLLC
• Senatobia Family Dentistry
• Senatobia Family Practice, P.C.
• Senatobia Municipal School District

• All providers in Senatobia, MS
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; 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.