SUMRALL DRUG STORE
NPI 1275613952
Pharmacy - Community/Retail Pharmacy in Sumrall, MS

Active since October 16, 2006CLIA 25D1088225 · Waiver
1109 HWY 42, SUMRALL, MS 39482(601) 758-4243(601) 758-4999 Get Directions Write a Review

NPPES record last updated: December 7, 2016. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Sumrall Drug Store NPPES

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

SUMRALL DRUG STORE (NPI 1275613952) is a healthcare organization registered as a community/retail pharmacy in Sumrall, Mississippi and active in the NPI registry since October 2006. The organization holds a CLIA Waiver certificate valid through June 1, 2028 and lists Beau Haden, Owner, as its authorized official.

NPPES Registry Identity

NPI1275613952
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSUMRALL DRUG STORE LLC
Location Address1109 HWY 42Sumrall, MS 39482-0246
Mailing AddressPo Box 120Sumrall, MS 39482-0120
Fax(601) 758-4999
Organization SubpartNo
Authorized OfficialBeau HadenOwner · (601) 758-4243
Enumeration DateOctober 16, 2006
Last NPPES UpdateDecember 7, 2016
NPI 1275613952 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License Licensed in MS · 00461011
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.

1109 HWY 42, Sumrall, MS 39482

Other Names 1

Doing Business AsSumrall Drug Store

Other Identifiers 2

Medicaid0092193MS
Other2047304Pk

Accepted Insurance

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 25D1088225

Sumrall Drug Store LLC · Sumrall, MS
Active · expires Jun 1, 2028
CLIA Number25D1088225
Laboratory TypePharmacy
Certificate Effective DateJune 2, 2026
Certificate Expiration DateJune 1, 2028
Laboratory DirectorTasha F. Haden
Laboratory Phone(601) 758-4243
Laboratory LocationSumrall Drug Store LLC1109 Highway 42, Sumrall, MS 39482
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Areas of Expertise CMS Part B claims 4

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Administration of influenza virus vaccine G0008
The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.
321 services319 patients
Influenza vaccine split virus, preservative free 90662
The Influenza Vaccine Split Virus, preservative-free, is a flu shot to protect against the influenza virus. It is made from parts of inactivated flu viruses and doesn't contain preservatives, reducing potential side effects. It helps your body develop immunity to the flu.
319 services317 patients
Administration of pneumococcal vaccine G0009
The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.
29 services29 patients
Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677
The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.
28 services28 patients

Medical Equipment Supplier Medicare DMEPOS 6

Medicare supplier enrollment and the product categories Sumrall Drug Store carries, from the Medicare DMEPOS supplier directory.

Sumrall Drug Store

DMEPOS supplier · Sumrall, MSOperated by Sumrall Drug Store LLC

Accepts Medicare assignment

Sumrall Drug Store agrees to accept the Medicare-approved amount as full payment for covered equipment and supplies. Medicare patients are not billed beyond the standard deductible and coinsurance.

PTAN (Medicare Supplier Number)20518481
Medicare Participant SinceOctober 3, 2012
Supplier Location1109 Hwy 42Sumrall, MS 39482
Supplier Specialties
Pharmacy

Medicare Product Categories

Epoetin
Epoetin is a man-made version of human erythropoietin (EPO)
Immunosuppressive Drugs
Immunosuppressive drugs require dosage, frequency, and route of administration to prevent or treat the rejection of an organ transplant
Infusion Drugs
Nebulizer Drugs
Albuterol, levalbuterol, and metaproterenol are all short-acting bronchodilators with beta-adrenergic stimulatory effect
Oral Anticancer Drugs
FDA anticancer drugs
Oral Antiemetic Drugs
FDA antiemetic drugs
Product categories are from the Medicare DMEPOS supplier directory. Contact the supplier to confirm current availability of specific items.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Pharmacist
1109 HWY 42
SUMRALL, MS 39482
Pharmacy (Long Term Care Pharmacy)
1109 HWY 42
SUMRALL, MS 39482
Pharmacy (Community/Retail Pharmacy)
1109 HWY 42
SUMRALL, MS 39482
Pharmacist
1109 HWY 42
SUMRALL, MS 39482

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 Sumrall Drug Store LLC's NPI number?

The NPI number for Sumrall Drug Store LLC is 1275613952. It was assigned to this organization in the NPPES registry on October 16, 2006. The provider is doing business as Sumrall Drug Store.

Where is Sumrall Drug Store LLC located?

Sumrall Drug Store LLC is located at 1109 Hwy 42, Sumrall, MS 39482. The listed phone number is (601) 758-4243.

What is Sumrall Drug Store LLC's specialty?

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

Does Sumrall Drug Store LLC accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Sumrall Drug Store accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

Does Sumrall Drug Store LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 25D1088225) is associated with this NPI, valid through June 1, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Sumrall Drug Store LLC accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter Health of Delaware, Ambetter from Absolute Total Care and Ambetter from Arizona Complete Health and 52 other insurers list Sumrall Drug Store LLC 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 Sumrall Drug Store LLC was last updated on December 7, 2016. NPI Profile syncs with the weekly NPPES data releases published by CMS.