SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC NPI 1104800440

NPI Information

NPI: 1104800440
Provider Name: SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC
Classification: Durable Medical Equipment & Medical Supplies - 332B00000X
Entity Type: Organization
Doing Business As: THE DIABETIC SHOPPE
Address: 1068 FACTORY DR
CHARLESTON, MS
ZIP 38921
Phone: (662) 647-6601

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NPI Details

SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC is a durable medical equipment medical supplies in Charleston, MS. The provider is a supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for a patient's use in the home and that are usable for an extended period of time. SOUTHERN DISCOUNT DRUGS OF CHARLESTON INC NPI is 1104800440. The provider is registered as an organization entity type.
The provider Is Doing Business As The Diabetic Shoppe.

The provider's business location address is:

1068 FACTORY DR
CHARLESTON, MS
ZIP 38921-620
Phone: (662) 647-6601
Fax: (662) 647-2411

The provider's authorized official is Robert Salmon .
The authorized official title is Pharmacist and has the following contact phone number (662) 647-2591.

The enumeration date for this NPI number is 11/30/2005 and was last updated on 7/11/2019.

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	License Number	License State	Primary
1	332B00000X	Durable Medical Equipment & Medical Supplies	1022	ALABAMA	No
2	332B00000X	Durable Medical Equipment & Medical Supplies	8226997-1714	UTAH	No
3	332B00000X	Durable Medical Equipment & Medical Supplies	056014	ARKANSAS	No
4	332B00000X	Durable Medical Equipment & Medical Supplies	DME18182	IDAHO	No
5	332B00000X	Durable Medical Equipment & Medical Supplies	NPC-0003778	OREGON	No
6	332B00000X	Durable Medical Equipment & Medical Supplies	MP00957	NEVADA	No
7	332B00000X	Durable Medical Equipment & Medical Supplies	P013728	ARIZONA	No
8	332B00000X	Durable Medical Equipment & Medical Supplies	06473/11.1	MISSISSIPPI	Yes

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
1	152800716	MEDICAID	ALASKA
2	1757861	MEDICAID	LOUISIANA
3	00040385	MEDICAID	MISSISSIPPI
4	175578701 175578702	MEDICAID	TEXAS
5	4057054	OTHER	TENNESSEE	BC TN

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: 3/30/2025

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