Provider Demographics
NPI:1174648422
Name:JIMS DISCOUNT DRUGS INC
Entity Type:Organization
Organization Name:JIMS DISCOUNT DRUGS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:
Authorized Official - Last Name:BUSBY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-947-6331
Mailing Address - Street 1:705 WINTER ST
Mailing Address - Street 2:
Mailing Address - City:LUCEDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39452-5729
Mailing Address - Country:US
Mailing Address - Phone:601-947-6331
Mailing Address - Fax:601-947-1455
Practice Address - Street 1:705 WINTER ST
Practice Address - Street 2:
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-5729
Practice Address - Country:US
Practice Address - Phone:601-947-6331
Practice Address - Fax:601-947-1455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-19
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MS015183336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS2512273OtherNCPDP NUMBER
MS00030174Medicaid
MS00030174Medicaid
MS00030174Medicaid