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PARK PLACE PHARMACY
NPI 1336433473
Pharmacy - Community/Retail Pharmacy in Petal, MS

Active since June 07, 2011CLIA 25D2235815 · Waiver
46 PARKWAY LN, PETAL, MS 39465(601) 450-3673(888) 959-2285 Get Directions Write a Review

NPPES record last updated: July 16, 2019. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Jul 16, 2019, Jul 19, 2018, Apr 19, 2018 and 2 more (5 updates tracked since 2016).

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

NPI1336433473
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameSOUTH MISSISSIPPI PHARMACISTS
Location Address46 PARKWAY LNPetal, MS 39465-3035
Mailing Address46 Parkway LnPetal, MS 39465-3035 · (601) 450-3673 · Fax (888) 959-2285
Phone(601) 450-3673
Fax(888) 959-2285
Organization SubpartNo
Authorized OfficialBrent LindleyOwner · (601) 450-3673
Enumeration DateJune 7, 2011
Last NPPES UpdateJuly 16, 20195 updates tracked since enumeration
✔ NPI 1336433473 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 5

★ Primary SpecialtyPharmacy · Community/Retail PharmacySuppliers
Taxonomy Code3336C0003X
License✔ Licensed in MS · 090361.1
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.
Also ListedDurable Medical Equipment & Medical SuppliesTaxonomy 332B00000X
Also ListedPharmacyTaxonomy 333600000X
Also ListedPharmacy · Compounding PharmacyTaxonomy 3336C0004X
Also ListedPharmacy · Long Term Care PharmacyTaxonomy 3336L0003X
46 PARKWAY LN, Petal, MS 39465
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Other Names 1

Doing Business AsPark Place Pharmacy

Other Identifiers 2

Medicaid07904554MS
Other2131489Pk

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 Arizona Complete Health and more.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 25D2235815

South Mississippi Pharmacists Inc Dba Park Place Pharmacy · Petal, MS
Active · expires Sep 12, 2027
CLIA Number25D2235815
Laboratory TypePharmacy
Certificate Effective DateSeptember 13, 2025
Certificate Expiration DateSeptember 12, 2027
Laboratory DirectorBrent J. Lindley
Laboratory Phone(601) 450-3673
Laboratory LocationSouth Mississippi Pharmacists Inc Dba Park Place Pharmacy46 Parkway Lane, Petal, MS 39465
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 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.

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.
17 services16 patients
Influenza vaccine, inactivated 90653
The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.
14 services14 patients

Other Providers at the Same Location NPPES

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

TAMMY BULLOCK RPH
Pharmacist
46 PARKWAY LN
PETAL, MS 39465
Forrest County (601) 450-3673

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.

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 Arizona Complete Health and 53 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.