Goodman Pharmacy, LLC

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

12429 Issued in MS

Legal business name

GOODMAN PHARMACY, LLC

Practice address

6888 Goodman Rd Ste 104
Olive Branch, MS 38654-8759

Phone

(662) 580-1035

NPI assigned

Nov 10, 2016

Last updated

Nov 10, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mary Glenn

Title

Pic/Managing Member

Phone

(662) 580-1035

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1478736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478736000000",
    "number": "1871035659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6888 GOODMAN RD STE 104",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6888 GOODMAN RD STE 104",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386548759",
            "telephone_number": "662-580-1035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODMAN PHARMACY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-10",
        "last_updated": "2016-11-10",
        "status": "A",
        "authorized_official_last_name": "GLENN",
        "authorized_official_first_name": "MARY",
        "authorized_official_title_or_position": "PIC/MANAGING MEMBER",
        "authorized_official_telephone_number": "662-580-1035"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "12429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Eason Gilbert, DDS
• Mark W Gilbert, D.D.S.
• Eleanor A Gill, D.M.D.
• Global Medical
• Goodman Dental Center PLLC
• Goodman Road Dental PLLC
• Grace Freight LLC
• Grace Residential Services , LLC
• Sierra Graham-Cooper, MSW
• Ja'Larna J Grant, MD

• Community/Retail Pharmacy in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Community/Retail Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2016; 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.