NPIMap

Organization Active NPI

Prime Urgent Medical Clinic

  • Clinic Pharmacy
  • Southaven, MS
National Provider Identifier
1891171351
Registry record updated May 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
14440 Issued in MS
Legal business name
PRIME URGENT MEDICAL CLINIC
Doing business as
Prime Urgent Medical Clinic
Practice address
176 Goodman Rd W
Southaven, MS 38671-9405
Phone
(662) 510-6981
Fax
(662) 510-6987
NPI assigned
Aug 7, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 10, 2016

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

Authorized official

Name
Clark Levi
Title
Member
Phone
(228) 447-3823

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic Pharmacy 3336C0002X 14440 MS Primary

Addresses

Primary practice location

176 Goodman Rd W
Southaven, MS 38671-9405

Mailing address

1019 Government St
Suite F
Ocean Springs, MS 39564-3860
Phone (288) 447-3823

Other identifiers 1

IdentifierTypeStateIssuer
2153376OtherPK

Other names 1

  • Prime Urgent Medical Clinic Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Urgent Medical Clinic 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.

Locations

1019 Government St
Ste F
Ocean Springs, MS 39564
Phone (228) 818-5111

NPI Registry JSON

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

{
    "created_epoch": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1462838400000",
    "number": "1891171351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1019 GOVERNMENT ST",
            "address_2": "SUITE F",
            "city": "OCEAN SPRINGS",
            "state": "MS",
            "postal_code": "395643860",
            "telephone_number": "288-447-3823",
            "fax_number": "228-447-3812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 GOODMAN RD W",
            "city": "SOUTHAVEN",
            "state": "MS",
            "postal_code": "386719405",
            "telephone_number": "662-510-6981",
            "fax_number": "662-510-6987"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME URGENT MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2016-05-10",
        "status": "A",
        "authorized_official_last_name": "LEVI",
        "authorized_official_first_name": "CLARK",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "228-447-3823"
    },
    "taxonomies": [
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MS",
            "license": "14440",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153376",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Prime Urgent Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Southaven, MS

Sources for this page

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