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Contact Information

MISSISSIPPI CVS PHARMACY, L.L.C.
401 HWY 12 EAST
STARKVILLE, MS39759
 Phone: 662-615-6033
 Fax: 401-770-7108
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Durable Medical Equipment & Medical Supplies

332B00000X 54 Other Medical Supply Company
Indicates primary specialty

NPI Profile & details for MISSISSIPPI CVS PHARMACY, L.L.C.

NPI # 1568660132
LBN Legal business name MISSISSIPPI CVS PHARMACY, L.L.C.
Authorized official SUSAN COLBERT - (DIRECTOR, PAYER RELATIONS)
Entity Organization
Organization subpart 1 No
Enumeration date 07/05/2007
Last updated 10/25/2011 - About 15 years ago
Identifiers
MS Medicaid 00237543
MS Medicaid 04109204-RX
MS Other 2586925 NCPDP
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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