NPIMap

Organization Active NPI

George County Pharmacy

  • Clinic Pharmacy
  • Lucedale, MS
National Provider Identifier
1841623808
Registry record updated Aug 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
12325/2.6 Issued in MS
Legal business name
GEORGE COUNTY PHARMACY
Doing business as
George County Pharmacy
Practice address
92 Ratliff St
Lucedale, MS 39452-6537
Phone
(601) 673-6181
Fax
(601) 766-4293
NPI assigned
Aug 14, 2013
Last updated
Aug 14, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2013

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

Authorized official

Name
Carman Walley
Title
Dop
Phone
(601) 673-6181

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 12325/2.6 MS Primary
Institutional Pharmacy 3336I0012X
Long Term Care Pharmacy 3336L0003X

Addresses

Primary practice location

92 Ratliff St
Lucedale, MS 39452-6537

Mailing address

92 Ratliff St
Lucedale, MS 39452-6537
Phone (601) 673-6181

Other identifiers 1

IdentifierTypeStateIssuer
2140621OtherPK

Other names 1

  • George County Pharmacy Doing business as

National Provider Directory

National Provider Directory
Tax ID family
George Countymobile Inf10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

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

NPI Registry JSON

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1376438400000",
    "number": "1841623808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "92 RATLIFF ST",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526537",
            "telephone_number": "601-673-6181",
            "fax_number": "601-766-4293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "92 RATLIFF ST",
            "city": "LUCEDALE",
            "state": "MS",
            "postal_code": "394526537",
            "telephone_number": "601-673-6181",
            "fax_number": "601-766-4293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE COUNTY PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-08-14",
        "last_updated": "2013-08-14",
        "status": "A",
        "authorized_official_last_name": "WALLEY",
        "authorized_official_first_name": "CARMAN",
        "authorized_official_title_or_position": "DOP",
        "authorized_official_telephone_number": "601-673-6181"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MS",
            "license": "12325/2.6",
            "primary": true
        },
        {
            "code": "3336I0012X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Institutional Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2140621",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "George County Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lucedale, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2013; 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.