Active NPI
Medical Plaza on Alcorn LLC
- Long Term Care Pharmacy
- Corinth, MS
National Provider Identifier
1750972618
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Long Term Care Pharmacy
- Legal business name
- MEDICAL PLAZA ON ALCORN LLC
- Practice address
- 111 Alcorn Dr
Corinth, MS 38834-9359 - Phone
- (662) 286-6991
- NPI assigned
- Feb 2, 2021
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Rick W Quinn, RPH
- Title
- Owner
- Phone
- (662) 286-6991
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Long Term Care Pharmacy | 3336L0003X | Primary |
Addresses
Primary practice location
111 Alcorn Dr
Corinth, MS 38834-9359
Mailing address
111 Alcorn Dr
Corinth, MS 38834-9359
Phone (662) 286-6991
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0095265 | Medicaid | MS |
National Provider Directory
National Provider DirectoryLocations
111 Alcorn Dr
Corinth, MS 38834
Phone (662) 286-6991
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Pharmacist
- Corinth, MS
- NPI 1326035528
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1612224000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1612224000000",
"number": "1750972618",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "111 ALCORN DR",
"city": "CORINTH",
"state": "MS",
"postal_code": "388349359",
"telephone_number": "662-286-6991"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "111 ALCORN DR",
"city": "CORINTH",
"state": "MS",
"postal_code": "388349359",
"telephone_number": "662-286-6991"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MEDICAL PLAZA ON ALCORN LLC",
"organizational_subpart": "NO",
"enumeration_date": "2021-02-02",
"last_updated": "2021-02-02",
"certification_date": "2021-02-02",
"status": "A",
"authorized_official_last_name": "QUINN",
"authorized_official_first_name": "RICK",
"authorized_official_middle_name": "W",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "662-286-6991",
"authorized_official_credential": "RPH"
},
"taxonomies": [
{
"code": "3336L0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Long Term Care Pharmacy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0095265",
"state": "MS"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Corinth, MS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 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.