Organization Active NPI

Medical Plaza on Alcorn LLC

  • Long Term Care Pharmacy
  • Corinth, MS
National Provider Identifier
1750972618
Registry record updated Feb 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Long Term Care PharmacyTaxonomy code 3336L0003X
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

Updated by the provider on Feb 2, 2021

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

Authorized official

Name
Rick W Quinn, RPHNPI 1326035528
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)CodeLicenseStatePrimary
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

IdentifierTypeStateIssuer
0095265MedicaidMS

National Provider Directory

National Provider Directory

Locations

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.

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.

Verify at the official NPI Registry.