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Contact Information

CLARKDALE PHARMACY AND GIFTS LLC
6935C HWY 145
MERIDIAN, MS39301
 Phone: 601-553-0668
 Fax: 601-553-3048
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for CLARKDALE PHARMACY AND GIFTS LLC

NPI # 1831580778
LBN Legal business name CLARKDALE PHARMACY AND GIFTS LLC
Authorized official DANIEL JOHNSON - (OWNER)
Entity Organization
Organization subpart 1 No
Enumeration date 02/13/2015
Last updated 07/06/2016 - About 10 years ago
Identifiers
MS License # 14215/1.1
MS Medicaid 00873551
Other 2150263 PK
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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