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MEDICAL PLAZA ON ALCORN LLC NPI 1750972618


NPI Information

NPI: 1750972618
Provider Name: MEDICAL PLAZA ON ALCORN LLC
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

CLIA Number: 25D2182251

Address:
111 ALCORN DR
CORINTH, MS
ZIP 38834
Phone: (662) 286-6991
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MEDICAL PLAZA ON ALCORN LLC is a long term care pharmacy pharmacy in Corinth, MS. The provider is a pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements. MEDICAL PLAZA ON ALCORN LLC NPI is 1750972618. The provider is registered as an organization entity type.

The provider's business location address is:

111 ALCORN DR
CORINTH, MS
ZIP 38834-359
Phone: (662) 286-6991

The provider's authorized official is Rick W Quinn .
The authorized official title is Owner and has the following contact phone number (662) 286-6991.

The CLIA number assigned to this NPI record is 25D2182251 - pharmacy with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/2/2021 and was last updated on 2/2/2021.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
13336L0003XPharmacyLong Term Care PharmacyYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
10095265MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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