Organization Active NPI

Caleb'S Hometown Pharmacy

  • Community/Retail Pharmacy
  • Collins, MS
National Provider Identifier
1679985378
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
13446 Issued in MS
Legal business name
CALEB'S HOMETOWN PHARMACY
Practice address
801 Main Street
Collins, MS 39428
Phone
(601) 765-5055
Fax
(601) 765-8544
NPI assigned
May 29, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

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

Authorized official

Name
Stephen Caleb Williamson, PHARM.D.NPI 1184973737
Title
Owner/Pharmacist
Phone
(601) 765-5055

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 13446 MS Primary

Addresses

Primary practice location

801 Main Street
Collins, MS 39428

Mailing address

PO Box 2396
Collins, MS 39428-2396

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20141224000382 MS Part B Supplier - Mass Immunization (Roster Biller Only) 1557684552 Practice locations: Collins, MS

National Provider Directory

National Provider Directory

Locations

801 Main St
Collins, MS 39428
Phone (601) 765-5055

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1401321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727740800000",
    "number": "1679985378",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2396",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394282396"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 MAIN STREET",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "39428",
            "telephone_number": "601-765-5055",
            "fax_number": "601-765-8544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CALEB'S HOMETOWN PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-29",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A",
        "authorized_official_last_name": "WILLIAMSON",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "CALEB",
        "authorized_official_title_or_position": "OWNER/PHARMACIST",
        "authorized_official_telephone_number": "601-765-5055",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "13446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Collins, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; 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.