GW Pharmacy LLC

Primary specialty

Specialty PharmacyTaxonomy code 3336S0011X

License

08886/02.6 Issued in MS

Legal business name

GW PHARMACY LLC

Practice address

201 N College St Ste 101
Brandon, MS 39042-4439

Phone

(601) 825-2897

NPI assigned

Apr 11, 2011

Organization subpart

No

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

Authorized official

Name

Waymon TigrettNPI 1962791178

Title

Owner

Phone

(601) 573-7788

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• GW Pharmacy Doing business as

Locations

Practitioners 1

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

• Waymon Tigrett

  • Pharmacist
  • Brandon, MS
  • NPI 1962791178
  NPD (past) Authorized official

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

{
    "created_epoch": "1302480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305504000000",
    "number": "1972893006",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 N COLLEGE ST",
            "address_2": "SUITE 101 BOX 9",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390424437"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 N COLLEGE ST STE 101",
            "city": "BRANDON",
            "state": "MS",
            "postal_code": "390424439",
            "telephone_number": "601-825-2897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GW PHARMACY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-11",
        "last_updated": "2011-05-16",
        "status": "A",
        "authorized_official_last_name": "TIGRETT",
        "authorized_official_first_name": "WAYMON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "601-573-7788"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336S0011X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Specialty Pharmacy",
            "state": "MS",
            "license": "08886/02.6",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP PROVIDER IDENTIFICATION NUMBER",
            "identifier": "2588284",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GW Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda L Gugliano, PSY.D.
• Tracy Guilbeau, SLP
• Wendy Gust
• Hope Marie Gustafson, LMSW
• William Bruce Guy II, FNP-C
• Johnny Roy Hales
• Brittany Lauren Hall, FNP-C
• Garrett Hall, DMD
• Mary Lydia Hall, AGPCNP
• Mollie Hall

• All providers in Brandon, MS
• Specialty Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2011; 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.