Provider Demographics
NPI:1770605974
Name:MCGUFFEE DRUGS INC
Entity type:Organization
Organization Name:MCGUFFEE DRUGS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:CHADWICK
Authorized Official - Last Name:PIERCE
Authorized Official - Suffix:
Authorized Official - Credentials:PHARMD
Authorized Official - Phone:601-382-7575
Mailing Address - Street 1:PO BOX 186
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:MS
Mailing Address - Zip Code:39153-0186
Mailing Address - Country:US
Mailing Address - Phone:601-782-4552
Mailing Address - Fax:601-782-9277
Practice Address - Street 1:122 MAIN ST
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:MS
Practice Address - Zip Code:39153-2202
Practice Address - Country:US
Practice Address - Phone:601-782-4552
Practice Address - Fax:601-782-9277
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:MCGUFFEE DRUGS INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2007-04-06
Last Update Date:2021-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
MS00309/1.13336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0032816Medicaid
2046745OtherPK
0570290001Medicare NSC