Provider Demographics
NPI:1003940750
Name:URGENT CARE PHARMACY, INC.
Entity Type:Organization
Organization Name:URGENT CARE PHARMACY, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LEA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:NORMAN
Authorized Official - Suffix:II
Authorized Official - Credentials:
Authorized Official - Phone:662-665-9660
Mailing Address - Street 1:2668 S HARPER RD STE 2
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-6770
Mailing Address - Country:US
Mailing Address - Phone:662-665-9660
Mailing Address - Fax:662-665-9659
Practice Address - Street 1:2668 S HARPER RD STE 2
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-6770
Practice Address - Country:US
Practice Address - Phone:662-665-9660
Practice Address - Fax:662-665-9659
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS05606332B00000X, 3336C0003X, 3336C0004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Not Answered3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Not Answered3336C0004XSuppliersPharmacyCompounding Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00330704Medicaid
MS2521210OtherNABP
MS2521210OtherNABP