Jim Bain'S Compounding Pharmacy

Primary specialty

Pharmacy TechnicianTaxonomy code 183700000X

License

2101-1513-3453-350 Issued in MS

Legal business name

JIM BAIN'S COMPOUNDING PHARMACY

Practice address

367 N Gloster St
Tupelo, MS 38804-3633

Phone

(662) 844-4530

Fax

(662) 844-4537

NPI assigned

Jun 12, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Jim Bain, PRH

Title

Owner/Pharamist

Phone

(662) 844-4530

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1760424659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7241",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388027241",
            "telephone_number": "662-844-4530",
            "fax_number": "662-844-4537"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "367 N GLOSTER ST",
            "city": "TUPELO",
            "state": "MS",
            "postal_code": "388043633",
            "telephone_number": "662-844-4530",
            "fax_number": "662-844-4537"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JIM BAIN'S COMPOUNDING PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-12",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BAIN",
        "authorized_official_first_name": "JIM",
        "authorized_official_title_or_position": "OWNER/PHARAMIST",
        "authorized_official_telephone_number": "662-844-4530",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PRH"
    },
    "taxonomies": [
        {
            "code": "183700000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacy Technician",
            "state": "MS",
            "license": "2101-1513-3453-350",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2586139",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Stacey Jennings
• Summer Renae Jennings, PMHNP-BC
• William T Jennings, M.D.
• Feras Jeradeh-Boursoulian, MD
• Jessica Roberts, PLLC
• Joan Armstrong
• John Russell, III, D.M.D.
• Joseph W Johnsey Jr., MD
• Amy L Johnson, CRNA
• Anthony Johnson

• Pharmacy Technician in Tupelo, MS
• Providers in Tupelo, MS by specialty
• Pharmacy Technician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.