Active NPI
Small Town Pharmacy LLC
- Community/Retail Pharmacy
- Port Gibson, MS
National Provider Identifier
1679017578
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 15089/1.1
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Sheri T Collins
- 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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00330665 | Medicaid | MS | |
| 2166886 | Other | PK |
National Provider Directory
National Provider DirectoryLocations
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.
-
- Pharmacist
- Port Gibson, MS
- NPI 1851476808
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.