Southwest Drugstore of Ms Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

0077500 Issued in MS

Legal business name

SOUTHWEST DRUGSTORE OF MS INC

Doing business as

SOUTHWEST DRUG STORE

Practice address

1601 Adeline St
Hattiesburg, MS 39401-6267

Phone

(601) 582-2481

Fax

(601) 545-3662

NPI assigned

Feb 7, 2007

Organization subpart

No

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

Authorized official

Name

Osher Moore

Title

Owner

Phone

(601) 898-7885

Specialties & licenses 2

Addresses

Other identifiers 3

Other names 1

• SOUTHWEST DRUG STORE Doing business as

Locations

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

{
    "created_epoch": "1170806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190678400000",
    "number": "1750421293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 ADELINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 ADELINE ST",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394016267",
            "telephone_number": "601-582-2481",
            "fax_number": "601-545-3662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST DRUGSTORE OF MS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-07",
        "last_updated": "2007-09-25",
        "status": "A",
        "authorized_official_last_name": "MOORE",
        "authorized_official_first_name": "OSHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-898-7885"
    },
    "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": "0077500",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER",
            "identifier": "2500913",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OTHER ID NUMBER-COMMERCIAL NUMBER",
            "identifier": "2500913",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0036251",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHWEST DRUG STORE",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Community/Retail Pharmacy in Hattiesburg, MS
• Providers in Hattiesburg, 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 Sep 25, 2007; 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.