NPIMap

Organization Active NPI

Noxubee General Critical Access Hospital

Doing business as Brooksville Pharmacy

  • Community/Retail Pharmacy
  • Brooksville, MS
National Provider Identifier
1750517009
Registry record updated Nov 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
06158011 Issued in MS
Legal business name
NOXUBEE GENERAL CRITICAL ACCESS HOSPITAL
Doing business as
Brooksville Pharmacy
Practice address
1556 N Oliver St
Brooksville, MS 39739-4003
Phone
(662) 738-5041
Fax
(662) 738-5043
NPI assigned
Jun 1, 2009
Last updated
Nov 8, 2021By the provider in NPPES
Organization subpart
Yes
Parent organization
NOXUBEE GENERAL CRITICAL ACCESS HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Nov 8, 2021

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

Authorized official

Name
Mary M Ebert
Title
Ceo
Phone
(662) 726-4231

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Community/Retail Pharmacy 3336C0003X 06158011 MS Primary

Addresses

Primary practice location

1556 N Oliver St
Brooksville, MS 39739-4003

Mailing address

PO Box 480
Macon, MS 39341
Phone (662) 738-5041

Other identifiers 2

IdentifierTypeStateIssuer
06689871MedicaidMS
2120473OtherPK

Other names 1

  • Brooksville Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Noxubee General Hospita7 organizations share this tax ID, including this one
Part of
Noxubee General Hospita

Other organizations with this tax ID 6

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1243814400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1636329600000",
    "number": "1750517009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 480",
            "city": "MACON",
            "state": "MS",
            "postal_code": "39341",
            "telephone_number": "662-738-5041",
            "fax_number": "662-738-5043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1556 N OLIVER ST",
            "city": "BROOKSVILLE",
            "state": "MS",
            "postal_code": "397394003",
            "telephone_number": "662-738-5041",
            "fax_number": "662-738-5043"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOXUBEE GENERAL CRITICAL ACCESS HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NOXUBEE GENERAL CRITICAL ACCESS HOSPITAL",
        "enumeration_date": "2009-06-01",
        "last_updated": "2021-11-08",
        "certification_date": "2021-11-08",
        "status": "A",
        "authorized_official_last_name": "EBERT",
        "authorized_official_first_name": "MARY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "662-726-4231"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "06158011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06689871",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2120473",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Brooksville Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brooksville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2021; 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.