NPIMap

Organization Active NPI

Baptist Memorial Hospital-Desoto, Inc.

Doing business as Baptist Desoto Outpatient Pharmacy

  • Community/Retail Pharmacy
  • Southaven, MS
National Provider Identifier
1790669331
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
BAPTIST MEMORIAL HOSPITAL-DESOTO, INC.
Doing business as
Baptist Desoto Outpatient Pharmacy
Practice address
7601 Southcrest Pkwy
Southaven, MS 38671-4739
Phone
(901) 227-4133
Fax
(901) 227-5004
NPI assigned
Aug 5, 2025
Last updated
Dec 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
BAPTIST MEMORIAL HOSPITAL-DESOTO, INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Authorized official

Name
Gregory M Duckett
Title
Evp Clo
Phone
(901) 227-5233

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X Primary

Addresses

Primary practice location

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Mailing address

7601 Southcrest Pkwy
Southaven, MS 38671-4739

Other names 1

  • Baptist Desoto Outpatient Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20260223001643 MS DME Supplier - Pharmacy 5597758755 Practice locations: Southaven, MS
O20260331003425 MS Part B Supplier - Mass Immunization (Roster Biller Only) 5597758755 Practice locations: Southaven, MS

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Baptist Memorial Hospital-Desoto, I7601 Southcrest Pkwy, Southaven, MS 38671-4739(662) 772-4150 Epoetin|Immunosuppressive Drugs|Infusion Drugs|Nebulizer Drugs|Oral Anticancer Drugs|Oral Antiemetic Drugs Accepts assignmentParticipating since May 16, 1994

National Provider Directory

National Provider Directory
Tax ID family
Baptist Memorial Hospital4 organizations share this tax ID, including this one
Part of
Baptist Memorial Hospital

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

7037 Hacks Cross Rd
Olive Branch, MS 38654
Phone (662) 890-2615

3121 Creech Dr
Ste 1
Southaven, MS 38672
Phone (662) 349-7329

363 Southcrest Cir
Ste 303
Southaven, MS 38671
Phone (901) 227-7465

Practitioners & affiliated clinicians

Practitioners 36

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 36

NPI Registry JSON

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

{
    "created_epoch": "1754352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766016000000",
    "number": "1790669331",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7601 SOUTHCREST PKWY",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386714739",
            "telephone_number": "901-227-4133",
            "fax_number": "901-227-5004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BAPTIST MEMORIAL HOSPITAL-DESOTO, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "BAPTIST MEMORIAL HOSPITAL-DESOTO, INC.",
        "enumeration_date": "2025-08-05",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A",
        "authorized_official_last_name": "DUCKETT",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "EVP CLO",
        "authorized_official_telephone_number": "901-227-5233"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Baptist Desoto Outpatient Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southaven, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.