SOUTH STREET PHARMACY NPI 1306906482

NPI Information

  • NPI: 1306906482
  • Provider Name: SOUTH STREET PHARMACY
  • Classification: Pharmacy - 3336C0003X
  • Specialization: Community/Retail Pharmacy
  • Entity Type: Organization
  • Address: 410 SOUTH ST
    CLEVELAND, MS
    ZIP 38732
  • Phone: (662) 843-6700

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NPI Details

SOUTH STREET PHARMACY is a community/retail pharmacy pharmacy in Cleveland, 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. SOUTH STREET PHARMACY NPI is 1306906482. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

410 SOUTH ST
CLEVELAND, MS
ZIP 38732-450
Phone: (662) 843-6700

The provider's authorized official is Michael Stuart Clark .
The authorized official title is PHARMACIST OWNEROwner and has the following contact phone number (662) 843-6700.

The enumeration date for this NPI number is 12/11/2006 and was last updated on 3/20/2018.

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
1183500000XPharmacist05857MISSISSIPPINo
23336C0003XPharmacyCommunity/Retail PharmacyYes
33336L0003XPharmacyLong Term Care PharmacyNo

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
12521513OTHERMISSISSIPPINABP NUMBER
204686806MEDICAIDMISSISSIPPI
309058522OTHERMISSISSIPPIMEDICAID DME
403181784MEDICAIDMISSISSIPPI

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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