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FREDS WESTSIDE PHARMACY INC
NPI 1265520290
Pharmacy - Community/Retail Pharmacy in Picayune, MS

Active since October 11, 2006
207 KIRKWOOD ST, PICAYUNE, MS 39466(601) 798-8888(601) 799-1012 Get Directions Write a Review

NPPES record last updated: August 5, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Freds Westside Pharmacy Inc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

FREDS WESTSIDE PHARMACY INC (NPI 1265520290) is a healthcare organization registered as a community/retail pharmacy in Picayune, Mississippi and active in the NPI registry since October 2006. The organization lists Roger G Cruse, Owner, as its authorized official.

NPPES Registry Identity

NPI1265520290
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameFREDS WESTSIDE PHARMACY INC
Location Address207 KIRKWOOD STPicayune, MS 39466-3835
Mailing Address207 Kirkwood StPicayune, MS 39466-3835 · (601) 798-8888 · Fax (601) 799-1012
Phone(601) 798-8888
Fax(601) 799-1012
Organization SubpartNo
Authorized OfficialRoger G CruseOwner · (601) 798-8888
Enumeration DateOctober 11, 2006
Last NPPES UpdateAugust 5, 2019
✔ NPI 1265520290 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
Definition
A pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes.
207 KIRKWOOD ST, Picayune, MS 39466
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Other Identifiers 2

Other01786239MS · Medicaid Dmerc
Medicaid0330105MS

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter from Arkansas Health & Wellness and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and revalidation status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Freds Westside Pharmacy Inc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by October 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateMississippiEnrollment IDO20100930041185DME · PharmacyDue dateOctober 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Medical Equipment Supplier Medicare DMEPOS 5

Medicare supplier enrollment and the product categories Fred's Westside Pharmacy carries, from the Medicare DMEPOS supplier directory.

Fred's Westside Pharmacy

DMEPOS supplier · Picayune, MSOperated by Freds Westside Pharmacy Inc
⋮

Does not accept Medicare assignment

Fred's Westside Pharmacy has not agreed to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients may be charged more than the Medicare-approved amount; confirm the expected cost with the supplier before ordering.

PTAN (Medicare Supplier Number)20632673
Medicare Participant SinceOctober 25, 1999
Supplier Location207 Kirkwood StPicayune, MS 39466
Phone(601) 798-8888
Supplier Specialties
Pharmacy

Medicare Product Categories

Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Blood Glucose Monitors/Supplies (Non-Mail Order)
Home blood glucose monitors including lancets, reagent strips, and other supplies necessary for the proper functioning of the device
Canes and/or Crutches
Standard Canes, Quad Canes, Offset Canes, Standard Crutches, Forearm Crutches
Walkers
Standard Walkers, Wheeled Walkers, Folding Walker
Nebulizer Equipment and/or Supplies
Nebulizers, Atomizers, Filters
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Freds Westside Pharmacy Inc's NPI number?

The NPI number for Freds Westside Pharmacy Inc is 1265520290. It was assigned to this organization in the NPPES registry on October 11, 2006.

Where is Freds Westside Pharmacy Inc located?

Freds Westside Pharmacy Inc is located at 207 Kirkwood St, Picayune, MS 39466. The listed phone number is (601) 798-8888.

What is Freds Westside Pharmacy Inc's specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.

Is Freds Westside Pharmacy Inc enrolled in Medicare?

Yes. Freds Westside Pharmacy Inc is registered in the Medicare PECOS enrollment system.

When is Freds Westside Pharmacy Inc's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare DME enrollment for this organization (Mississippi, Pharmacy) is due for revalidation by October 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

Does Freds Westside Pharmacy Inc accept Medicare assignment for medical equipment?

No. As a Medicare medical equipment supplier, Fred's Westside Pharmacy does not accept Medicare assignment for equipment and supplies, so patients may be charged more than the Medicare-approved amount. Confirm the expected cost with the supplier before ordering.

What insurance does Freds Westside Pharmacy Inc accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arkansas Health & Wellness and 48 other insurers list Freds Westside Pharmacy Inc as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Freds Westside Pharmacy Inc was last updated on August 5, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.