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OKOLONA PHARMACY LLC NPI 1083131593


NPI Information

NPI: 1083131593
Provider Name: OKOLONA PHARMACY LLC
Classification: Pharmacy - 3336L0003X
Entity Type: Organization

Specialization: Long Term Care Pharmacy

Address:
210 W MAIN ST
OKOLONA, MS
ZIP 38860
Phone: (662) 447-0300
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OKOLONA PHARMACY LLC is a long term care pharmacy pharmacy in Okolona, 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. OKOLONA PHARMACY LLC NPI is 1083131593. The provider is registered as an organization entity type.

The provider's business location address is:

210 W MAIN ST
OKOLONA, MS
ZIP 38860-425
Phone: (662) 447-0300

The provider's authorized official is Tony Smith .
The authorized official title is Owner and has the following contact phone number (901) 831-8669.

The enumeration date for this NPI number is 8/25/2017 and was last updated on 5/23/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
100479277MEDICAIDMISSISSIPPI

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: 4/28/2024

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