Waldrip Pharms LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

Legal business name

WALDRIP PHARMS LLC

Practice address

425 Desoto Ave
Clarksdale, MS 38614-5214

Phone

(662) 627-0100

Fax

(662) 627-0102

NPI assigned

Jan 11, 2007

Organization subpart

No

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

Authorized official

Name

Dena Ferman

Title

Third Party Plan Coordinator

Phone

(314) 993-6000

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• Medicap Pharmacy Doing business as

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Harold Keith Waldrip

  • Pharmacist
  • Batesville, MS
  • NPI 1306540935
  NPD
• Chad Jeremy Braddock, PHARMD

  • Pharmacist
  • Clarksdale, MS
  • NPI 1912225343
  NPD (past)

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

{
    "created_epoch": "1168473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678147200000",
    "number": "1679623995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 DESOTO AVE",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386145214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 DESOTO AVE",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386145214",
            "telephone_number": "662-627-0100",
            "fax_number": "662-627-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALDRIP PHARMS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-11",
        "last_updated": "2023-03-07",
        "status": "A",
        "authorized_official_last_name": "FERMAN",
        "authorized_official_first_name": "DENA",
        "authorized_official_title_or_position": "THIRD PARTY PLAN COORDINATOR",
        "authorized_official_telephone_number": "314-993-6000"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "0332901MC",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2518554",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330233",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Medicap Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Urgent & Primary Care of Clarksdale LLC
• Sarah Vance, PHARMD
• Victoryhomehealthandhospice20
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Mary Kate Walhood, CCC-SLP
• James Edward Warrington Sr., M.D.
• Maha Wasef, MD
• Dinah Washington
• Rosalyn Washington

• Community/Retail Pharmacy in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; 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.