NPIMap

Organization Active NPI

Clayton Drug Store, Inc.

  • Community/Retail Pharmacy
  • Collins, MS
National Provider Identifier
1699782003
Registry record updated Oct 28, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
00553/01.1 Issued in MS
Legal business name
CLAYTON DRUG STORE, INC.
Practice address
216 Main St
Collins, MS 39428
Phone
(601) 765-4323
Fax
(601) 765-4962
NPI assigned
Aug 1, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2017

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

Authorized official

Name
Rick A Chambers, PHARM.D.NPI 1871358945
Title
President
Phone
(901) 481-1511

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 00553/01.1 MS Primary

Addresses

Primary practice location

216 Main St
Collins, MS 39428

Mailing address

PO Box 787
Collins, MS 39428-0787
Phone (601) 765-4323

Other identifiers 3

IdentifierTypeStateIssuer
00040348OtherMSMEDICAID DME
00030996MedicaidMS
2501648OtherMSNCPDP

National Provider Directory

National Provider Directory

Locations

216 Main St
Collins, MS 39428
Phone (601) 765-4323

Practitioners & affiliated clinicians

Practitioners 3

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": "1154390400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1509148800000",
    "number": "1699782003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 787",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "394280787",
            "telephone_number": "601-765-4323",
            "fax_number": "601-765-4962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 MAIN ST",
            "city": "COLLINS",
            "state": "MS",
            "postal_code": "39428",
            "telephone_number": "601-765-4323",
            "fax_number": "601-765-4962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLAYTON DRUG STORE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-01",
        "last_updated": "2017-10-28",
        "status": "A",
        "authorized_official_last_name": "CHAMBERS",
        "authorized_official_first_name": "RICK",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "901-481-1511",
        "authorized_official_credential": "PHARM.D."
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00553/01.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID DME",
            "identifier": "00040348",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00030996",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2501648",
            "state": "MS"
        }
    ],
    "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 28, 2017; 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.