Clarksdale Pharmacy, LLC
Organization Active NPI Specialty Pharmacy · Clarksdale, MS
NPI 1770146128 · NPPES record last updated Sep 11, 2025
Key facts
- NPI
- 1770146128
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Specialty Pharmacy 3336S0011X
- Legal business name
- CLARKSDALE PHARMACY, LLC
- Practice address
- 425 Desoto Ave
Clarksdale, MS 38614-5214 - Phone
- (662) 627-0100
- Fax
- (662) 627-0102
- NPI assigned
- Apr 20, 2019
- Organization subpart
- No
Authorized official
- Name
- William Eric Poff, R.PH.
- Title
- President/Owner
- Phone
- (662) 624-1011
Practitioners 2
-
William Eric Poff, R.PH.
-
Chad Jeremy Braddock, PHARMD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20201008000898 | MS | Part B Supplier - Pharmacy | 7012336209 | Practice locations: Clarksdale, MS |
| O20240419000848 | MS | Part B Supplier - Independent Clinical Laboratory | 7012336209 | Practice locations: Clarksdale, MS |
National Provider Directory
Locations
425 Desoto Ave
Clarksdale, MS 38614
Phone (662) 627-0100
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialty Pharmacy | 3336S0011X | Yes |
Addresses
Primary practice location
425 Desoto Ave
Clarksdale, MS 38614-5214
Mailing address
425 Desoto Ave
Clarksdale, MS 38614-5214
Phone (662) 627-0100
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1160882 | Other | MS | STATE OF MS BUSINESS ID |
Electronic endpoints
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mail@clarksdalepharmacy.com | Direct |
Other providers in Clarksdale, MS
- Clarksdale Hma Physican Management, LLC
- Clarksdale Hma Physician Management LLC
- Clarksdale Ms Opco LLC
- Clarksdale Ms Operating LLC
- Clarksdale Municipal School District
- Clarksdale Physical Therapy Associates, Inc.
- Clarksdale Physical Therapy Inc
- Clarksdale Regional Medical Center, Inc.
- Clarksdale Regional Physicians, LLC
- Clarksdale Regional Physicians, LLC
All providers in Clarksdale, MS · Specialty Pharmacy in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 11, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.