Mississippi Discount Drugs of Clinton Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

00837/01.1 Issued in MS

Legal business name

MISSISSIPPI DISCOUNT DRUGS OF CLINTON INC

Doing business as

Mississippi Discount Drugs Health Mart

Practice address

224 Clinton Blvd
Clinton, MS 39056-5126

Phone

(601) 924-5212

Fax

(601) 924-4649

NPI assigned

Jul 2, 2005

Last updated

Aug 2, 2011By 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

Cary Parks, ACCOUNTING

Title

General MGR and Owner

Phone

(601) 924-5212

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• MISSISSIPPI DISCOUNT DRUGS HEALTH MART Doing business as

Locations

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

{
    "created_epoch": "1120262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1312243200000",
    "number": "1730186982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "224 CLINTON BLVD",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565126",
            "telephone_number": "601-924-5212",
            "fax_number": "601-924-4649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "224 CLINTON BLVD",
            "city": "CLINTON",
            "state": "MS",
            "postal_code": "390565126",
            "telephone_number": "601-924-5212",
            "fax_number": "601-924-4649"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MISSISSIPPI DISCOUNT DRUGS OF CLINTON INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-02",
        "last_updated": "2011-08-02",
        "status": "A",
        "authorized_official_last_name": "PARKS",
        "authorized_official_first_name": "CARY",
        "authorized_official_title_or_position": "GENERAL MGR AND OWNER",
        "authorized_official_telephone_number": "601-924-5212",
        "authorized_official_credential": "ACCOUNTING"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00837/01.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330602",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2501561",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MISSISSIPPI DISCOUNT DRUGS HEALTH MART",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Taylor S Miller
• Elise Ades Milliman, RN
• Amanda M Ming, RDN
• Mississippi College
• Mississippi CVS Pharmacy LLC (CVS Pharmacy # 10020)
• Mississippi Discount Drugs of Clinton, Inc. (Mississippi Discount Drugs Health Mart)
• Mississippi Orthopedic Supply, LLC
• Carvina Vadoll Mitchell, B.S, M.S
• Jayla Mondy
• Felicia Moore

• Community/Retail Pharmacy in Clinton, MS
• Providers in Clinton, 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 Aug 2, 2011; 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.