Organization Active NPI

CDS Home Care, Inc.

Doing business as CDS Home Care

  • Specialty Pharmacy
  • Vicksburg, MS
National Provider Identifier
1902871809
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Specialty PharmacyTaxonomy code 3336S0011X
Legal business name
CDS HOME CARE, INC.
Doing business as
CDS Home Care
Practice address
1911 Mission 66
Suite H
Vicksburg, MS 39180-3762
Phone
(601) 883-2999
Fax
(601) 883-2877
NPI assigned
Feb 22, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Authorized official

Name
Mr. Reagan L Brown, RPH
Title
Pharmacist
Phone
(601) 883-2999

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X 05542/02.2 MS
Parenteral & Enteral Nutrition Supplies (DME) 332BP3500X 05542/02.2 MS
Oxygen Equipment & Supplies (DME) 332BX2000X 05542/02.2 MS
Home Infusion Therapy Pharmacy 3336H0001X 05542/02.2 MS
Long Term Care Pharmacy 3336L0003X 05542/02.2 MS
Specialty Pharmacy 3336S0011X MS Primary

Addresses

Primary practice location

1911 Mission 66
Suite H
Vicksburg, MS 39180-3762

Mailing address

1911 Mission 66
Suite H
Vicksburg, MS 39180-3762
Phone (601) 883-2999

Other identifiers 3

IdentifierTypeStateIssuer
00440953MedicaidMS
2521652OtherMSNCPDP
00330687MedicaidMS

Other names 1

  • CDS Home Care Doing business as

National Provider Directory

National Provider Directory

Locations

119 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-9988

NPI Registry JSON

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

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1757548800000",
    "number": "1902871809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1911 MISSION 66",
            "address_2": "SUITE H",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803762",
            "telephone_number": "601-883-2999",
            "fax_number": "601-883-2877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1911 MISSION 66",
            "address_2": "SUITE H",
            "city": "VICKSBURG",
            "state": "MS",
            "postal_code": "391803762",
            "telephone_number": "601-883-2999",
            "fax_number": "601-883-2877"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CDS HOME CARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-22",
        "last_updated": "2025-09-11",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "REAGAN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PHARMACIST",
        "authorized_official_telephone_number": "601-883-2999",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPH"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "MS",
            "license": "05542/02.2",
            "primary": false
        },
        {
            "code": "332BP3500X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Parenteral & Enteral Nutrition",
            "state": "MS",
            "license": "05542/02.2",
            "primary": false
        },
        {
            "code": "332BX2000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Oxygen Equipment & Supplies",
            "state": "MS",
            "license": "05542/02.2",
            "primary": false
        },
        {
            "code": "3336H0001X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Home Infusion Therapy Pharmacy",
            "state": "MS",
            "license": "05542/02.2",
            "primary": false
        },
        {
            "code": "3336L0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Long Term Care Pharmacy",
            "state": "MS",
            "license": "05542/02.2",
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "MS",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00440953",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2521652",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00330687",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CDS Home Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Vicksburg, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2025; 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.