Gatlins Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00799011 Issued in MS

Legal business name

GATLINS PHARMACY INC

Doing business as

Gatlins Pharmacy

Practice address

18 First Ave
Tishomingo, MS 38873-8441

Phone

(662) 438-6605

Fax

(662) 438-6680

NPI assigned

Sep 27, 2006

Last updated

Jul 19, 2018By 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

Jesse DoranNPI 1447738299

Title

Owner

Phone

(662) 438-6605

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• GATLINS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

Tax ID family

Gatlins Pharmacy Inc2 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.

• Gatlins Pharmacy Inc

  dba Gatlin's Pharmacy Inc LTC

  • Long Term Care Pharmacy
  • Tishomingo, MS
  • NPI 1013777317
  NPD tax ID

Locations

Practitioners 4

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.

• Jesse Bart Doran

  • Pharmacist
  • Tishomingo, MS
  • NPI 1447738299
  NPD Authorized official
• Christopher Bishop, PHARMD

  • Pharmacist
  • Tishomingo, MS
  • NPI 1003431610
  NPD (past)
• Robert Galloway

  • Pharmacist
  • Tishomingo, MS
  • NPI 1336627181
  NPD (past)
• Stanley Page

  • Pharmacist
  • Tishomingo, MS
  • NPI 1295213056
  NPD (past)

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

{
    "created_epoch": "1159315200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1531958400000",
    "number": "1518058288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 369",
            "city": "TISHOMINGO",
            "state": "MS",
            "postal_code": "388730369",
            "telephone_number": "662-438-6605",
            "fax_number": "662-438-6680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 FIRST AVE",
            "city": "TISHOMINGO",
            "state": "MS",
            "postal_code": "388738441",
            "telephone_number": "662-438-6605",
            "fax_number": "662-438-6680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GATLINS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-27",
        "last_updated": "2018-07-19",
        "status": "A",
        "authorized_official_last_name": "DORAN",
        "authorized_official_first_name": "JESSE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-438-6605"
    },
    "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": "00799011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00039276",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2043431",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GATLINS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• William Austin Carmack
• Jesse Bart Doran
• Jenny Katherine Farris, FNP-C
• Robert Galloway
• Gatlins Pharmacy Inc (Gatlin's Pharmacy Inc LTC)
• Samantha Joanne Justice, NP
• Harrison Christopher Moss, DC
• North Mississippi Primary Health Care, Inc. (Tishomingo Health Care Associates)
• Stanley Page
• Theresa Parsons, MA, LPC-S

• Community/Retail Pharmacy in Tishomingo, MS
• Providers in Tishomingo, 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 Jul 19, 2018; 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.