Picayune Drug Co., Inc.

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

License

055-05477-9 Issued in MS

Legal business name

PICAYUNE DRUG CO., INC.

Practice address

110 Highway 11 N
Picayune, MS 39466-3312

Phone

(601) 798-4846

Fax

(601) 798-4825

NPI assigned

Jun 26, 2006

Last updated

Apr 12, 2021By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Andrew L Failla, R PHNPI 1093933798

Title

President

Phone

(601) 798-4846

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS2 enrollments

Enrollment records 2

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Picayune Drug Co., Inc.

  • Community/Retail Pharmacy
  • Picayune, MS
  • NPI 1922027622

  1456478635

  Same PAC ID

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Picayune Drug Co., Inc.

  • Community/Retail Pharmacy
  • Picayune, MS
  • NPI 1922027622

  O20210412000984

  Same enrollment

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.

• Andrew L. Failla, R.PH

  • Pharmacist
  • Picayune, MS
  • NPI 1093933798
  Authorized official Same address or phone

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618185600000",
    "number": "1689601957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 10",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394660010",
            "telephone_number": "601-798-4846",
            "fax_number": "601-798-4825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 HIGHWAY 11 N",
            "city": "PICAYUNE",
            "state": "MS",
            "postal_code": "394663312",
            "telephone_number": "601-798-4846",
            "fax_number": "601-798-4825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PICAYUNE DRUG CO., INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-26",
        "last_updated": "2021-04-12",
        "certification_date": "2021-03-24",
        "status": "A",
        "authorized_official_last_name": "FAILLA",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "601-798-4846",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R PH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "055-05477-9",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Phoenix Health, LLC
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• Picayune Chiropractic, PLLC
• Picayune Clinic LLC (Crosby Memorial Hospital)
• Picayune Drug Co. North
• Picayune Drug Co., Inc.
• Picayune Eye Clinic
• Picayune Family Health Center
• Picayune Family Practice Clinic, LLC (Picayune Family Clinic)
• Picayune General Dentistry, Inc.

• Durable Medical Equipment & Medical Supplies in Picayune, MS
• Providers in Picayune, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2021; 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.