MCM of Mississippi LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

14900/1.1 Issued in MS

Legal business name

MCM OF MISSISSIPPI LLC

Doing business as

houston family pharmacy

Practice address

339 E Madison St
Houston, MS 38851-2322

Phone

(662) 631-5055

Fax

(662) 631-5097

NPI assigned

Aug 24, 2016

Last updated

Jan 9, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Christopher Carter

Title

Owner

Phone

(662) 542-8464

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• houston family pharmacy Doing business as

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

{
    "created_epoch": "1471996800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578528000000",
    "number": "1770038382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 E MADISON ST",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388512322",
            "telephone_number": "662-542-8464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "339 E MADISON ST",
            "city": "HOUSTON",
            "state": "MS",
            "postal_code": "388512322",
            "telephone_number": "662-631-5055",
            "fax_number": "662-631-5097"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MCM OF MISSISSIPPI LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-08-24",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A",
        "authorized_official_last_name": "CARTER",
        "authorized_official_first_name": "CHRISTOPHER",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-542-8464"
    },
    "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": "14900/1.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2163837",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "08372765",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "houston family pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "houston family pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Christopher W Lancaster, LCSW
• Danny Derek Lantrip, NP
• Lotts of Love
• Madison East Internal Medicine LLC
• Amanda Brand Mahan, FNP-C
• Med Express of Mississppi
• Mississippi State Department of Health (Tombigbee Home Health Agency 4B)
• Mississippi State Department of Health
• Natalie Mitchell, LCSW
• Derek Moeller, M.D.

• Community/Retail Pharmacy in Houston, MS
• Providers in Houston, 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 Jan 9, 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.