Provider Demographics
NPI:1508006669
Name:DISCOUNT DRUGS OF MS LLC
Entity Type:Organization
Organization Name:DISCOUNT DRUGS OF MS LLC
Other - Org Name:ACKERMAN DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:BERRY
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:601-859-3940
Mailing Address - Street 1:104 CLAIREMONT DRIVE
Mailing Address - Street 2:
Mailing Address - City:RIDGELAND
Mailing Address - State:MS
Mailing Address - Zip Code:39157
Mailing Address - Country:US
Mailing Address - Phone:601-720-7884
Mailing Address - Fax:601-855-2133
Practice Address - Street 1:518 CHESTER ST
Practice Address - Street 2:SUITE 2
Practice Address - City:ACKERMAN
Practice Address - State:MS
Practice Address - Zip Code:39735-9517
Practice Address - Country:US
Practice Address - Phone:662-285-9333
Practice Address - Fax:662-285-9335
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2018-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X, 3336L0003X
MS080193336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
No3336L0003XSuppliersPharmacyLong Term Care Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS1433391Medicaid
2119101OtherPK