PARK PLACE PHARMACY
NPI 1336433473
Pharmacy - Community/Retail Pharmacy in Petal, MS
About Park Place Pharmacy NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PARK PLACE PHARMACY (NPI 1336433473) is a healthcare organization registered as a community/retail pharmacy in Petal, Mississippi and active in the NPI registry since June 2011. The organization holds a CLIA Waiver certificate valid through September 12, 2027 and lists Brent Lindley, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 5
Other Names 1
Other Identifiers 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and revalidation status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Park Place Pharmacy is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Revalidation Due Date
Revalidation due by February 28, 2027
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.
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 25D2235815
South Mississippi Pharmacists Inc Dba Park Place Pharmacy · Petal, MSAreas of Expertise CMS Part B claims 2
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.
Other Providers at the Same Location NPPES
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
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 South Mississippi Pharmacists's NPI number?
The NPI number for South Mississippi Pharmacists is 1336433473. It was assigned to this organization in the NPPES registry on June 7, 2011. The provider is doing business as Park Place Pharmacy.
Where is South Mississippi Pharmacists located?
South Mississippi Pharmacists is located at 46 Parkway Ln, Petal, MS 39465. The listed phone number is (601) 450-3673.
What is South Mississippi Pharmacists's specialty?
The primary specialty registered for this NPI is Pharmacy, specializing in Community/Retail Pharmacy, with taxonomy code 3336C0003X.
Is South Mississippi Pharmacists enrolled in Medicare?
Yes. South Mississippi Pharmacists is registered in the Medicare PECOS enrollment system.
When is South Mississippi Pharmacists's Medicare revalidation due?
According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Mississippi, Mass Immunization (Roster Biller Only)) is due for revalidation by February 28, 2027. 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 South Mississippi Pharmacists hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 25D2235815) is associated with this NPI, valid through September 12, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does South Mississippi Pharmacists 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 52 other insurers list South Mississippi Pharmacists 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 South Mississippi Pharmacists was last updated on July 16, 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.
# Park Place Pharmacy · NPI 1336433473
Community/Retail Pharmacy organization in Petal, Mississippi. Organization record, active in the CMS NPPES registry since June 7, 2011.
## Identity
- **NPI:** 1336433473 (Entity type: Organization)
- **Enumerated:** June 7, 2011
- **Primary specialty:** Pharmacy - Community/Retail Pharmacy · taxonomy 3336C0003X
- **Legal business name:** South Mississippi Pharmacists
- **Organization subpart:** No
- **Authorized official:** Brent Lindley, OWNER
## Practice location
- **Address:** 46 PARKWAY LN, Petal, MS 39465-3035
- **Phone:** (601) 450-3673 · **Fax:** (888) 959-2285
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Medicare revalidation due:** February 28, 2027 (Non-DME Part B, Mississippi, Mass Immunization (Roster Biller Only)) · CMS Revalidation Due Date List, October 2026 release
## Record status
- **NPPES last updated:** July 16, 2019
- **Other identifiers:** Medicaid 07904554 (MS); Other 2131489
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1336433473) · Data from the CMS NPPES public registry.