FREDS WESTSIDE PHARMACY INC NPI 1265520290

NPI Information

  • NPI: 1265520290
  • Provider Name: FREDS WESTSIDE PHARMACY INC
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Address: 207 KIRKWOOD ST
    PICAYUNE, MS
    ZIP 39466
  • Phone: (601) 798-8888

Map and Directions

Get Directions

NPI Details

FREDS WESTSIDE PHARMACY INC is a community/retail pharmacy pharmacy in Picayune, MS. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. FREDS WESTSIDE PHARMACY INC NPI is 1265520290. The provider is registered as an organization entity type.

The provider's business location address is:

207 KIRKWOOD ST
PICAYUNE, MS
ZIP 39466-835
Phone: (601) 798-8888
Fax: (601) 799-1012

The provider's authorized official is Roger G Cruse .
The authorized official title is Owner and has the following contact phone number (601) 798-8888.

The enumeration date for this NPI number is 10/11/2006 and was last updated on 8/5/2019.

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 Taxonomy Specialization License Number License State Primary
13336C0003XPharmacyCommunity/Retail 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
101786239OTHERMISSISSIPPIMEDICAID DMERC
20330105MEDICAIDMISSISSIPPI

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: 11/21/2025

NPI Synchronization or Removal

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

Previous NPI
Next NPI