Organization Active NPI

Small Town Pharmacy LLC

  • Community/Retail Pharmacy
  • Port Gibson, MS
National Provider Identifier
1679017578
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
15089/1.1 Issued in MS
Legal business name
SMALL TOWN PHARMACY LLC
Practice address
1005 Market St
Port Gibson, MS 39150-2337
Phone
(601) 437-5121
Fax
(601) 437-5102
NPI assigned
Dec 12, 2016
Last updated
Feb 16, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

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

Authorized official

Name
Ms. Sheri T CollinsNPI 1851476808
Title
Owner
Phone
(601) 437-5121

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
Community/Retail Pharmacy 3336C0003X 15089/1.1 MS Primary

Addresses

Primary practice location

1005 Market St
Port Gibson, MS 39150-2337

Mailing address

1005 Market St
Port Gibson, MS 39150-2337
Phone (601) 437-5121

Other identifiers 2

IdentifierTypeStateIssuer
00330665MedicaidMS
2166886OtherPK

National Provider Directory

National Provider Directory

Locations

1005 Market St
Port Gibson, MS 39150
Phone (601) 437-5121

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1481500800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771200000000",
    "number": "1679017578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1005 MARKET ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502337",
            "telephone_number": "601-437-5121",
            "fax_number": "601-437-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MARKET ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502337",
            "telephone_number": "601-437-5121",
            "fax_number": "601-437-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMALL TOWN PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-12-12",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A",
        "authorized_official_last_name": "COLLINS",
        "authorized_official_first_name": "SHERI",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-437-5121",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "15089/1.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330665",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2166886",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Gibson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; 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.