LIBERTY DRUG STORE, INC. – NPI #1639124183
Pharmacist

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

LIBERTY DRUG STORE, INC. is a pharmacist located in LIBERTY, MS. NPPES has assigned the NPI number 1639124183 to LIBERTY DRUG STORE, INC. on May 23, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. The primary taxonomy selected by this provider is 183500000X from the Health Care Provider Taxonomy code set, which is classified as Pharmacist.

The NPI profile was previously updated about 3 years ago on Dec 07, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for LIBERTY DRUG STORE, INC. below.

NPI Profile for
LIBERTY DRUG STORE, INC.

NPI Number
1639124183
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
LIBERTY DRUG STORE, INC.
Primary location
110 E MAIN ST
LIBERTY, MS 39645
Phone: (601) 657-8051 Fax: (601) 657-8049
Mailing address
PO BOX 217
LIBERTY, MS 39645-0217
Phone: (601) 657-8051 Fax: (601) 657-8049
Organization Subpart
No
Authorized Official
RONALD BLALOCK
PRESIDENT/PHARMACIST
Phone: (601) 657-8051
Updated
Certification Date
Dec 07, 2023

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for LIBERTY DRUG STORE, INC.

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidMS00440833
medicaidMS00330466
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
183500000X
- Pharmacist (Primary)
MS T08879

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.