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MANTACHIE PHARMACY LLC NPI 1992292536


NPI Information

NPI: 1992292536
Provider Name: MANTACHIE PHARMACY LLC

Doing Business As: MANTACHIE PHARMACY

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
3309 HIGHWAY 371 N
MANTACHIE, MS
ZIP 38855
Phone: (662) 322-3901
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MANTACHIE PHARMACY LLC is a community/retail pharmacy pharmacy in Mantachie, 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. MANTACHIE PHARMACY LLC NPI is 1992292536. The provider is registered as an organization entity type.
The provider Is Doing Business As Mantachie Pharmacy.

The provider's business location address is:

3309 HIGHWAY 371 N
MANTACHIE, MS
ZIP 38855
Phone: (662) 322-3901
Fax: (662) 640-4116

The provider's authorized official is Katlyn Spradling .
The authorized official title is Pharmacist and has the following contact phone number (662) 282-7000.

The enumeration date for this NPI number is 4/19/2018 and was last updated on 8/22/2023.


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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1332B00000XDurable Medical Equipment & Medical SuppliesNo
2333600000XPharmacyNo
33336C0003XPharmacyCommunity/Retail Pharmacy17079/1.1MISSISSIPPIYes

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
12177084OTHERPK

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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