1740279819 NPI number — TRANSCRIPT PHARMACY, INC.

Table of content: (NPI 1740279819)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1740279819 NPI number — TRANSCRIPT PHARMACY, INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
TRANSCRIPT PHARMACY, INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1740279819
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2506 LAKELAND DR
Provider Second Line Business Mailing Address:
SUITE 201
Provider Business Mailing Address City Name:
FLOWOOD
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39232-7640
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-420-4041
Provider Business Mailing Address Fax Number:
601-420-4040

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2506 LAKELAND DR
Provider Second Line Business Practice Location Address:
SUITE 201
Provider Business Practice Location Address City Name:
FLOWOOD
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39232-7640
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-420-4041
Provider Business Practice Location Address Fax Number:
601-420-4040
Provider Enumeration Date:
10/20/2005

Additional Information

Authorized Official

Authorized Official Last Name:
OSBON
Authorized Official First Name:
CLIFTON
Authorized Official Middle Name:
Authorized Official Title or Position:
VICE PRESIDENT
Authorized Official Telephone Number:
601-420-4041

Provider Taxonomy Codes

  • Taxonomy code: 333600000X , with the licence number:  05693/02.6 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 00330721 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 54012091 , issued by the state of ( KY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2008321000A , issued by the state of ( IN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2521272 , issued by the state of ( TN ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2521272 . This is a "NCPDP" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2673129 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".




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