NPIMap

Organization Active NPI

Diamond Grove Center

  • Institutional Pharmacy
  • Louisville, MS
National Provider Identifier
1619000593
Registry record updated Dec 13, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Institutional PharmacyTaxonomy code 3336I0012X
License
03665 Issued in MS
Legal business name
DIAMOND GROVE CENTER
Practice address
2311 Highway 15 S
Louisville, MS 39339-7071
Phone
(662) 779-0119
Fax
(662) 779-0126
NPI assigned
Mar 13, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2007

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

Authorized official

Name
Patrick Swoopes
Title
Administrator
Phone
(662) 779-0119

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Institutional Pharmacy 3336I0012X 03665 MS Primary

Addresses

Primary practice location

2311 Highway 15 S
Louisville, MS 39339-7071

Mailing address

2311 Highway 15 S
Louisville, MS 39339-7071
Phone (662) 779-0119

Other identifiers 4

IdentifierTypeStateIssuer
00020375OtherMSBLUE CROSS PROVIDER #
00330450OtherMSDIAMOND GROVE CENTER
00220411MedicaidMS
00220801MedicaidMS

National Provider Directory

National Provider Directory
Tax ID family
Diamond Grove Center5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

NPI Registry JSON

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197504000000",
    "number": "1619000593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2311 HIGHWAY 15 S",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393397071",
            "telephone_number": "662-779-0119",
            "fax_number": "662-779-0126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2311 HIGHWAY 15 S",
            "city": "LOUISVILLE",
            "state": "MS",
            "postal_code": "393397071",
            "telephone_number": "662-779-0119",
            "fax_number": "662-779-0126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIAMOND GROVE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-13",
        "last_updated": "2007-12-13",
        "status": "A",
        "authorized_official_last_name": "SWOOPES",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "662-779-0119"
    },
    "taxonomies": [
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": "MS",
            "license": "03665",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS PROVIDER #",
            "identifier": "00020375",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIAMOND GROVE CENTER",
            "identifier": "00330450",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220411",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00220801",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2007; 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.