NPIMap

Organization Active NPI

Sullivan'S Discount Drugs, Inc

  • Durable Medical Equipment & Medical Supplies
  • Kosciusko, MS
National Provider Identifier
1558400549
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
License
0023301.1 Issued in MS
Legal business name
SULLIVAN'S DISCOUNT DRUGS, INC
Doing business as
Sullivan's Discount Drugs
Practice address
109 Northside Ctr
Kosciusko, MS 39090-3254
Phone
(662) 289-3234
Fax
(662) 289-3030
NPI assigned
Feb 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. David Charles Hudson, R.PH.NPI 1083648364
Title
Manager
Phone
(662) 289-3234

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 0023301.1 MS Primary

Addresses

Primary practice location

109 Northside Ctr
Kosciusko, MS 39090-3254

Mailing address

109 Northside Ctr
Kosciusko, MS 39090-3254
Phone (662) 289-3234

Other identifiers 1

IdentifierTypeStateIssuer
00440359MedicaidMS

Other names 1

  • Sullivan's Discount Drugs Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1558400549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 NORTHSIDE CTR",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903254",
            "telephone_number": "662-289-3234",
            "fax_number": "662-289-3030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 NORTHSIDE CTR",
            "city": "KOSCIUSKO",
            "state": "MS",
            "postal_code": "390903254",
            "telephone_number": "662-289-3234",
            "fax_number": "662-289-3030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SULLIVAN'S DISCOUNT DRUGS, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUDSON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "CHARLES",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "662-289-3234",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "0023301.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00440359",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sullivan's Discount Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kosciusko, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.