South Street Pharmacy in Cleveland - Pharmacist
South Street Pharmacy - NPI 1306906482
South Street Pharmacy is a Pharmacist in Cleveland, Mississippi. South Street Pharmacy practices all healthcare services and medical treatments related to Pharmacist. The NPI Number for South Street Pharmacy is 1306906482. The last update date is 2018-03-20.
South Street Pharmacy's current location address is Po Box 1748, Cleveland, Mississippi. You can contact this provider via phone number 6628436700. The mailing address for South Street Pharmacy is Po Box 1748, Cleveland, Mississippi. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | South Street Pharmacy |
|---|---|
| Address | Po Box 1748, Cleveland, Mississippi |
| Phone Number | 6628436700 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | PHARMACIST |
|---|---|
| Authorized Official Name | Clark Stuart Michael |
| Telephone Number | 6628436700 |
NPI Number Detail
| NPI Number | 1306906482 |
|---|---|
| Provider Enumeration Date | 2006-12-11 |
| Last Updated Date | 2018-03-20 |
Provider Mailing Address Detail
| Address | Po Box 1748 |
|---|---|
| City | Cleveland |
| State | Mississippi (MS) |
| Post Code | 387321748 |
| Phone Number | 6628436700 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pharmacist |
|---|---|
| Taxonomy | 183500000X |
| Licence No | 5857 |
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Definition: An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or m |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4686806 | MS | -- | |
| 3181784 | MS | -- | |
| 2521513 | MS | NABP NUMBER | |
| 9058522 | MS | MEDICAID DME |
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What is the unique identifier code issued to South Street Pharmacy by the Centers for Medicare & Medicaid Services (CMS)?
The South Street Pharmacy has been assigned the NPI (National Provider Identifier) 1306906482. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Where is the South Street Pharmacy located?
The South Street Pharmacy is located at Po Box 1748, Cleveland, MS 387321748.
What is South Street Pharmacy's area of expertise and its corresponding taxonomy classification?
The South Street Pharmacy's field of specialization is Pharmacist, and it falls under the taxonomy code 183500000X, which categorizes healthcare providers based on their areas of practice.
On what date did the Centers for Medicare & Medicaid Services issue the 1306906482 to South Street Pharmacy?
The South Street Pharmacy received its 1306906482 assignment from the Centers for Medicare & Medicaid Services on 2006-12-11.
As of what date were the details pertaining to South Street Pharmacy last refreshed?
The information related to the South Street Pharmacy, including its address, specialty, and other relevant details, was last updated on 2018-03-20.
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