Organization Active NPI

Magnolia Drugs Inc

Doing business as Magnolia Drugs

  • Community/Retail Pharmacy
  • Myrtle, MS
National Provider Identifier
1619535515
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
MAGNOLIA DRUGS INC
Doing business as
Magnolia Drugs
Practice address
1757 Highway 178 West
Suite B
Myrtle, MS 38650
Phone
(662) 988-7030
Fax
(662) 988-7014
NPI assigned
Jun 5, 2019
Last updated
Nov 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Authorized official

Name
Martin Crotts
Title
Owner
Phone
(662) 988-7030

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU
Community/Retail Pharmacy 3336C0003X NU Primary

Addresses

Primary practice location

1757 Highway 178 West
Suite B
Myrtle, MS 38650

Mailing address

1757 Highway 178 W Ste B
Myrtle, MS 38650-9233
Phone (662) 988-7030

Other identifiers 1

IdentifierTypeStateIssuer
007726090MedicaidMS

Other names 1

  • Magnolia Drugs Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200505000552 MS Part B Supplier - Pharmacy 5193156271 Practice locations: Myrtle, MS

National Provider Directory

National Provider Directory

Locations

1757 Highway 178 W
#B
Myrtle, MS 38650
Phone (662) 988-7030

NPI Registry JSON

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

{
    "created_epoch": "1559692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1763337600000",
    "number": "1619535515",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1757 HIGHWAY 178 W STE B",
            "city": "MYRTLE",
            "state": "MS",
            "postal_code": "386509233",
            "telephone_number": "662-988-7030",
            "fax_number": "662-988-7014"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1757 HIGHWAY 178 WEST",
            "address_2": "SUITE B",
            "city": "MYRTLE",
            "state": "MS",
            "postal_code": "38650",
            "telephone_number": "662-988-7030",
            "fax_number": "662-988-7014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA DRUGS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-06-05",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A",
        "authorized_official_last_name": "CROTTS",
        "authorized_official_first_name": "MARTIN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-988-7030"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007726090",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Magnolia Drugs",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Magnolia Drugs",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Myrtle, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2025; 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.