Provider Demographics
NPI:1417900291
Name:ROCKY L MCGARITY INC
Entity Type:Organization
Organization Name:ROCKY L MCGARITY INC
Other - Org Name:EDWARDS DISCOUNT DRUGS
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROCKY
Authorized Official - Middle Name:
Authorized Official - Last Name:MCGARITY
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:601-947-4941
Mailing Address - Street 1:103 W FRONTAGE RD
Mailing Address - Street 2:SUITE A
Mailing Address - City:LUCEDALE
Mailing Address - State:MS
Mailing Address - Zip Code:39452-5836
Mailing Address - Country:US
Mailing Address - Phone:601-947-4941
Mailing Address - Fax:601-766-3010
Practice Address - Street 1:103 W FRONTAGE RD
Practice Address - Street 2:SUITE A
Practice Address - City:LUCEDALE
Practice Address - State:MS
Practice Address - Zip Code:39452-5836
Practice Address - Country:US
Practice Address - Phone:601-947-4941
Practice Address - Fax:601-766-3010
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-19
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X, 333600000X, 3336C0004X, 3336L0003X
MS01104/1.13336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
No3336C0004XSuppliersPharmacyCompounding Pharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
2043800OtherPK
MS0330314Medicaid
MS0440455Medicaid
1220180001Medicare NSC