Provider Demographics
NPI:1750494670
Name:SARTIN'S DISCOUNT DRUGS, INC
Entity Type:Organization
Organization Name:SARTIN'S DISCOUNT DRUGS, INC
Other - Org Name:SARTIN'S DISCOUNT DRUGS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALVIN
Authorized Official - Middle Name:CRAIG
Authorized Official - Last Name:SARTIN
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:228-864-3514
Mailing Address - Street 1:4300 15TH ST
Mailing Address - Street 2:SUITE # 1
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39501-2524
Mailing Address - Country:US
Mailing Address - Phone:228-864-3514
Mailing Address - Fax:228-864-2402
Practice Address - Street 1:4300 15TH ST
Practice Address - Street 2:SUITE # 1
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39501-2524
Practice Address - Country:US
Practice Address - Phone:228-864-3514
Practice Address - Fax:228-864-2402
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS01681/01.1332B00000X, 333600000X, 3336C0003X
MS0168101.13336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00005016Medicaid
MS00034748Medicaid
MS2513186OtherNABP
MS2513186OtherNABP
MS2513186OtherNABP
MS00034748Medicaid
1303050001Medicare NSC