Organization Active NPI

Barnett Apothecary, LLC

  • Pharmacist
  • Iuka, MS
National Provider Identifier
1669481875
Registry record updated Apr 6, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
05564011 Issued in MS
Legal business name
BARNETT APOTHECARY, LLC
Practice address
606 Battleground Dr
Iuka, MS 38852
Phone
(662) 423-9994
Fax
(662) 423-9987
NPI assigned
Aug 5, 2006
Last updated
Apr 6, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2011

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

Authorized official

Name
Mr. John Stephen Barnett, RPH
Title
Owner Pharmacist
Phone
(662) 423-9994

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 05564011 MS Primary

Addresses

Primary practice location

606 Battleground Dr
Iuka, MS 38852

Mailing address

PO Box 60
Iuka, MS 38852
Phone (662) 423-9994

Other identifiers 1

IdentifierTypeStateIssuer
0330696MedicaidMS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230201001376 MS Part B Supplier - Pharmacy 1850504549 Practice locations: Iuka, MS

National Provider Directory

National Provider Directory

Locations

606 Battleground Dr
Iuka, MS 38852
Phone (662) 423-9994

NPI Registry JSON

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

{
    "created_epoch": "1154736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302048000000",
    "number": "1669481875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "38852",
            "telephone_number": "662-423-9994",
            "fax_number": "662-423-9987"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 BATTLEGROUND DR",
            "city": "IUKA",
            "state": "MS",
            "postal_code": "38852",
            "telephone_number": "662-423-9994",
            "fax_number": "662-423-9987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BARNETT APOTHECARY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-05",
        "last_updated": "2011-04-06",
        "status": "A",
        "authorized_official_last_name": "BARNETT",
        "authorized_official_first_name": "JOHN",
        "authorized_official_middle_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER PHARMACIST",
        "authorized_official_telephone_number": "662-423-9994",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "05564011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330696",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Iuka, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2011; 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.