Provider Demographics
NPI:1013966639
Name:TODDS PHARMACY INC
Entity Type:Organization
Organization Name:TODDS PHARMACY INC
Other - Org Name:MEDICAP PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:TODD
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:662-563-0266
Mailing Address - Street 1:110 HIGHWAY 51 N
Mailing Address - Street 2:
Mailing Address - City:BATESVILLE
Mailing Address - State:MS
Mailing Address - Zip Code:38606-2347
Mailing Address - Country:US
Mailing Address - Phone:662-563-0266
Mailing Address - Fax:662-563-0288
Practice Address - Street 1:110 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:BATESVILLE
Practice Address - State:MS
Practice Address - Zip Code:38606-2347
Practice Address - Country:US
Practice Address - Phone:662-563-0266
Practice Address - Fax:662-563-0288
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-09
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS02563/01.13336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS2517780OtherNCPDP NUMBER
MS00330103Medicaid
MS00330103Medicaid
MS2517780OtherNCPDP NUMBER