Active NPI
Controlex Enterprises, Inc.
Doing business as Palace Sav-Rex #638
- Community/Retail Pharmacy
- Pascagoula, MS
National Provider Identifier
1912148362
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Community/Retail Pharmacy
- License
- 05009/01.2
- Legal business name
- CONTROLEX ENTERPRISES, INC.
- Doing business as
- Palace Sav-Rex #638
- Practice address
- 641 Delmas Ave
Pascagoula, MS 39567-4226 - Phone
- (228) 769-6362
- NPI assigned
- Mar 16, 2009
- Last updated
- Mar 16, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Modena Starr Cannon
- Title
- Operations Manager
- Phone
- (228) 769-7067
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Community/Retail Pharmacy | 3336C0003X | 05009/01.2 | NU | Primary |
Addresses
Primary practice location
641 Delmas Ave
Pascagoula, MS 39567-4226
Mailing address
1420 Ingalls Ave
Pascagoula, MS 39567-5650
Phone (228) 769-7067
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 2520434 | Other | MS | NCPDP |
| 00330593 | Medicaid | MS |
Other names 1
- Palace Sav-Rex #638
National Provider Directory
National Provider Directory- Tax ID family
- Controlex Enterprises Inc
Other organizations with this tax ID 3
Organizations that report the same tax identification number in the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1237161600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1237161600000",
"number": "1912148362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1420 INGALLS AVE",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395675650",
"telephone_number": "228-769-7067",
"fax_number": "228-762-1756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "641 DELMAS AVE",
"city": "PASCAGOULA",
"state": "MS",
"postal_code": "395674226",
"telephone_number": "228-769-6362"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CONTROLEX ENTERPRISES, INC.",
"organizational_subpart": "NO",
"enumeration_date": "2009-03-16",
"last_updated": "2009-03-16",
"status": "A",
"authorized_official_last_name": "CANNON",
"authorized_official_first_name": "MODENA",
"authorized_official_middle_name": "STARR",
"authorized_official_title_or_position": "OPERATIONS MANAGER",
"authorized_official_telephone_number": "228-769-7067",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "3336C0003X",
"taxonomy_group": "",
"desc": "Pharmacy, Community/Retail Pharmacy",
"state": "NU",
"license": "05009/01.2",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "2520434",
"state": "MS"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00330593",
"state": "MS"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Palace Sav-Rex #638",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Pascagoula, MS
- Joshua Coker, M.D.
- Devon Elijah Coleman, DMD
- Community Rehab of Greenville Inc (Seaside Physical Therapy)
- Complete Health Urgicare, Inc (Complete Health Urgent Care, Inc)
- John T Connors, NP-C
- Controlex Enterprises, Inc. (Southwest Savrex #632)
- Controlex Entrprises, Inc (Gulf Coast Sav-Rex #631)
- Gary Cook
- Cooper Family Medical Center Inc.
- Kevin Scott Cooper, MD,MPH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.