NPIMap

Organization Active NPI

Van Dev Enterprises Inc

Doing business as McDaniel Pharmacy

  • Community/Retail Pharmacy
  • Port Gibson, MS
National Provider Identifier
1932204880
Registry record updated Feb 25, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
00680 Issued in MS
Legal business name
VAN DEV ENTERPRISES INC
Doing business as
McDaniel Pharmacy
Practice address
1005 Market St
Port Gibson, MS 39150-2337
Phone
(601) 437-5121
Fax
(601) 437-5102
NPI assigned
Sep 14, 2006
Last updated
Feb 25, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2010

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

Authorized official

Name
Daphyne Vandevender, PD
Title
Owner
Phone
(601) 437-5121

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X 00680 MS Primary

Addresses

Primary practice location

1005 Market St
Port Gibson, MS 39150-2337

Mailing address

PO Box 1024
Port Gibson, MS 39150-1024
Phone (601) 437-5121

Other identifiers 2

IdentifierTypeStateIssuer
2506737OtherNCPDP PROVIDER IDENTIFICATION NUMBER
0330665MedicaidMS

Other names 1

  • MCDANIEL PHARMACY Doing business as

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1158192000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1267056000000",
    "number": "1932204880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1024",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391501024",
            "telephone_number": "601-437-5121",
            "fax_number": "601-437-5102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1005 MARKET ST",
            "city": "PORT GIBSON",
            "state": "MS",
            "postal_code": "391502337",
            "telephone_number": "601-437-5121",
            "fax_number": "601-437-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN DEV ENTERPRISES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-14",
        "last_updated": "2010-02-25",
        "status": "A",
        "authorized_official_last_name": "VANDEVENDER",
        "authorized_official_first_name": "DAPHYNE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-437-5121",
        "authorized_official_credential": "PD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "MS",
            "license": "00680",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2506737",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0330665",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MCDANIEL PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Port Gibson, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 2010; 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.