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Contact Information

SPORTS MEDICINE PHARMACY LLC
4506 LAKELAND DR
FLOWOOD, MS39232-9583
 Phone: 601-949-9105
 Fax: 601-351-5974
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pharmacy

333600000X 58 Medical Supply Company with Pharmacist
 

Clinic Pharmacy

3336C0002X 58 Medical Supply Company with Pharmacist
 

Community/Retail Pharmacy

3336C0003X 58 Medical Supply Company with Pharmacist
 

Specialty Pharmacy

3336S0011X 58 Medical Supply Company with Pharmacist
Indicates primary specialty

NPI Profile & details for SPORTS MEDICINE PHARMACY LLC

NPI Number 1912452921
LBN Legal business name SPORTS MEDICINE PHARMACY LLC
Authorized official CHRISTOPHER MCLAURIN - (DIRECTOR OF PHARMACY SERVICES)
Entity Organization
Organization subpart 1 No
Enumeration date 08/19/2016
Last updated 10/23/2025 - About 7 months ago
Identifiers
MS License # 14908
MS Medicaid 06600515
Other 2162491 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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