Controlex Enterprises, Inc.

Primary specialty

PharmacyTaxonomy code 333600000X

License

00842/01.2 Issued in MS

Legal business name

CONTROLEX ENTERPRISES, INC.

Practice address

1714 Denny Ave
Pascagoula, MS 39567-3303

Phone

(228) 762-7192

NPI assigned

Oct 19, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Modena S Cannon

Title

Pharmacy Operations Manager

Phone

(228) 769-7067

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• SOUTHWEST SAVREX #632 Doing business as

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Controlex Entrprises, Inc

  • Community/Retail Pharmacy
  • Pascagoula, MS
  • NPI 1972685097

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992887020",
    "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": "1714 DENNY AVE",
            "city": "PASCAGOULA",
            "state": "MS",
            "postal_code": "395673303",
            "telephone_number": "228-762-7192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONTROLEX ENTERPRISES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CANNON",
        "authorized_official_first_name": "MODENA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PHARMACY OPERATIONS MANAGER",
        "authorized_official_telephone_number": "228-769-7067",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "MS",
            "license": "00842/01.2",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00092568",
            "state": "MS"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NCPDP",
            "identifier": "2506422",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SOUTHWEST SAVREX #632",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Devon Elijah Coleman, DMD
• Community Rehab of Greenville Inc
• Complete Health Urgicare, Inc
• John T Connors, NP-C
• Controlex Enterprises, Inc.
• Controlex Entrprises, Inc
• Gary Cook
• Cooper Family Medical Center Inc.
• Kevin Scott Cooper, MD,MPH
• Tiffany Dawn Cooper, BSW

• All providers in Pascagoula, MS
• Pharmacy in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.