NPIMap

Organization Active NPI

South Central Regional Medical Center

Doing business as South Central Specialty Pharmacy

  • Community/Retail Pharmacy
  • Laurel, MS
National Provider Identifier
1841913068
Registry record updated Dec 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
Legal business name
SOUTH CENTRAL REGIONAL MEDICAL CENTER
Doing business as
South Central Specialty Pharmacy
Practice address
1220 Jefferson Street
Suite 3
Laurel, MS 39440
Phone
(601) 335-8940
Fax
(601) 516-8966
NPI assigned
Sep 22, 2022
Last updated
Dec 2, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SOUTH CENTRAL REGIONAL MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Dec 2, 2025

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

Authorized official

Name
Stephen East
Title
Cfo
Phone
(601) 399-6144

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Retail Pharmacy 3336C0003X Primary
Specialty Pharmacy 3336S0011X

Addresses

Primary practice location

1220 Jefferson Street
Suite 3
Laurel, MS 39440

Mailing address

1620 W. Northwest Hwy
Suite 100
Grapevine, TX 76051
Phone (817) 572-0009

Other names 1

  • South Central Specialty Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230519001410 MS DME Supplier - Pharmacy 8325946411 Practice locations: Laurel, MS

Other NPIs with the same Medicare PAC ID 8

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

National Provider Directory

National Provider Directory
Tax ID family
South Central Reg Med C27 organizations share this tax ID, including this one
Part of
South Central Reg Med C

Other organizations with this tax ID 26

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

View all 26

Member of 2

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

Locations

1220 Jefferson St
Ste 3
Laurel, MS 39440
Phone (601) 335-8940

Ownership & related parties

All facility ownership & control disclosures 9

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Jones County Rest HomeEllisville, MS, CCN 255336 Skilled nursing facility Operational/Managerial Control (100%) Apr 10, 2010
Comfort Care Nursing CenterLaurel, MS, CCN 255352 Skilled nursing facility Operational/Managerial Control (100%) Aug 1, 1994
Comfort Care Home HealthLaurel, MS, CCN 257099 Home health agency Operational/Managerial Control (100%) Jul 1, 1991
Comfort Care HospiceLaurel, MS, CCN 251512 Hospice Operational/Managerial Control (100%) Jul 18, 1992
South Central Family Medicine & Urgent CareLaurel, MS, CCN 258581 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Mar 1, 2014
South Central PediatricsLaurel, MS, CCN 258510 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
Ellisville Pediatric ClinicEllisville, MS, CCN 253437 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Dec 14, 2012
South Central Primary Care ServicesLaurel, MS, CCN 258649 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Jan 1, 2020
South Central Urgent CareLaurel, MS, CCN 258688 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Jan 1, 2020
Jul 1, 2025

Owned or controlled facilities with NPI records 9

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

NPI Registry JSON

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

{
    "created_epoch": "1663804800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764633600000",
    "number": "1841913068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 W. NORTHWEST HWY",
            "address_2": "SUITE 100",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "76051",
            "telephone_number": "817-572-0009",
            "fax_number": "817-572-0221"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1220 JEFFERSON STREET",
            "address_2": "SUITE 3",
            "city": "LAUREL",
            "state": "MS",
            "postal_code": "39440",
            "telephone_number": "601-335-8940",
            "fax_number": "601-516-8966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SOUTH CENTRAL REGIONAL MEDICAL CENTER",
        "enumeration_date": "2022-09-22",
        "last_updated": "2025-12-02",
        "certification_date": "2025-12-02",
        "status": "A",
        "authorized_official_last_name": "EAST",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "601-399-6144"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Central Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "South Central Specialty Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Laurel, MS

Sources for this page

Verify at the official NPI Registry.