Mitchells Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHY.002804-IR Issued in LA

Legal business name

MITCHELLS PHARMACY INC

Practice address

202 E Main St
Jonesboro, LA 71251

Phone

(318) 259-7466

Fax

(318) 259-8019

NPI assigned

Jan 8, 2007

Organization subpart

No

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

Authorized official

Name

Dwayne Mitchell, RPHNPI 1144907445

Title

Owner & Pharmacist

Phone

(318) 259-7466

Specialties & licenses 5

Addresses

Other identifiers 2

Other names 1

• MITCHELLS PHARMACY INC Doing business as

Medicare fee-for-service enrollment

Enrolled in LA2 enrollments

Enrollment records 2

Tax ID family

Mitchells Pharmacy Inc3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Mitchells Pharmacy Inc

  • Long Term Care Pharmacy
  • Jonesboro, LA
  • NPI 1164062667
  NPD tax ID
• Mitchell'S Pharmacy

  • Community/Retail Pharmacy
  • Chatham, CA
  • NPI 1881380616
  NPD tax ID

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Dwayne R Mitchell, RPH

  • Pharmacist
  • Jonesboro, LA
  • NPI 1144907445
  NPD (past) Authorized official
• Jessica Clement

  • Pharmacist
  • Jonesboro, LA
  • NPI 1457079147
  NPD (past)
• Stephanie Deann Laffitte

  • Pharmacist
  • Jonesboro, LA
  • NPI 1730673658
  NPD (past)
• Austin M Peavy, PHARMD

  • Pharmacist
  • Alexandria, LA
  • NPI 1891463592
  NPD (past)
• Brittany Williams, PHARMD

  • Pharmacist
  • Jonesboro, LA
  • NPI 1093559007
  NPD (past)

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

{
    "created_epoch": "1168214400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529452800000",
    "number": "1881742880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 E MAIN ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "712513202",
            "telephone_number": "318-259-7466",
            "fax_number": "318-259-8019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "202 E MAIN ST",
            "city": "JONESBORO",
            "state": "LA",
            "postal_code": "71251",
            "telephone_number": "318-259-7466",
            "fax_number": "318-259-8019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MITCHELLS PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-08",
        "last_updated": "2018-06-20",
        "status": "A",
        "authorized_official_last_name": "MITCHELL",
        "authorized_official_first_name": "DWAYNE",
        "authorized_official_title_or_position": "OWNER & PHARMACIST",
        "authorized_official_telephone_number": "318-259-7466",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "LA",
            "license": "2804",
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "LA",
            "license": "2804",
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "LA",
            "license": "PHY.002804-IR",
            "primary": true
        },
        {
            "code": "3336C0004X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Compounding Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "LA",
            "license": "2804",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2032909",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1261319",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MITCHELLS PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MITCHELLS PHARMACY INC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Mercy Medical Health Center
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• Miss-Lou Addiction Clinic
• Dwayne R Mitchell, RPH
• Mitchells Pharmacy Inc
• Brittney Latoya Moore, MSW. BSW. CSW, MHP
• Tracey Lynn Morgan
• Morning Light, Inc.
• Ciera Murphy
• Purvis Glen Nash, RPH

• All providers in Jonesboro, LA
• Community/Retail Pharmacy in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.