Organization
MS State Dept of Health
Provider's NPPES record last updated: October 22, 2024
Overview
- Entity Type
- Organization
- NPI
- 1376606582
- Primary Specialty
- Pharmacy — Long Term Care Pharmacy
- Practice Location
- Jackson, Mississippi
- Organization Subpart
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 6:40 AM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Pharmacy
Long Term Care Pharmacy
Suppliers
A pharmacy that dispenses medicinal preparations delivered to patients residing within an intermediate or skilled nursing facility, including intermediate care facilities, hospice, assisted living facilities, group homes, and other forms of congregate living arrangements.
Taxonomy code 3336L0003X Public Health or Welfare
Agencies
Definition to come...
Taxonomy code 251K00000XPharmacy
Clinic Pharmacy
Suppliers
A pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist.
Taxonomy code 3336C0002X
Provider-Reported License Information
- Public Health or Welfare (Mississippi)
- 01085 05.1
- Pharmacy (Mississippi)
- 0108505.1
Practice Locations
Practice Location
3156 Lawson Street
Jackson, Mississippi 39213
Phone: (601) 713-3457
Record Information
- Enumeration Date
- December 18, 2006
- Provider's NPPES Record Last Updated
- October 22, 2024
- Certification Date
- October 22, 2024
- NPISignal NPPES Dataset
- August 2026
See Something Wrong?
Incorrect provider information
Everything on this page comes directly from the NPPES data CMS publishes. NPISignal cannot edit a provider's record — only the provider or organization can, directly through NPPES.
Update a record through NPPESSomething wrong with this page?
If NPISignal is displaying this data incorrectly — a formatting error, a broken link, a mismatch with the source file — let us know.
Report a display issue