Haggard Drug Store Inc.

Primary specialty

PharmacistTaxonomy code 183500000X

License

00411/01.1 Issued in MS

Legal business name

HAGGARD DRUG STORE INC.

Practice address

301 3Rd St
Clarksdale, MS 38614-4307

Phone

(662) 624-8361

Fax

(662) 624-5678

NPI assigned

Oct 17, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Marvin Carey Jones, R.PH.

Title

President Pharmacist

Phone

(662) 624-8361

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1841370137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 3RD ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144307",
            "telephone_number": "662-624-8361",
            "fax_number": "662-624-5678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "301 3RD ST",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386144307",
            "telephone_number": "662-624-8361",
            "fax_number": "662-624-5678"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAGGARD DRUG STORE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-17",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "MARVIN",
        "authorized_official_middle_name": "CAREY",
        "authorized_official_title_or_position": "PRESIDENT PHARMACIST",
        "authorized_official_telephone_number": "662-624-8361",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "R.PH."
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Pharmacist",
            "state": "MS",
            "license": "00411/01.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00032212",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Guardian Angel Adult Day Services LLC
• Meghann E Gulledge Yee, M.ED.
• Cody Renaldo Gullick, FNP-C
• Mohamad F Hadidi, M.D.
• Undra L Haggan, NURSE PRACTITIONER
• Clifford Hall, M.D.
• Alvin Ray Hamilton Jr., CRNA
• Lakedra T Hampton, MSW
• Africa Joanalene Harris-Johnson, DPT
• Catherine Harris, MSW

• Pharmacist in Clarksdale, MS
• Providers in Clarksdale, MS by specialty
• Pharmacist 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.