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ELLISVILLE DRUG
NPI 1396829438
Pharmacy - Community/Retail Pharmacy in Ellisville, MS

Active since October 25, 2006
915 HILL ST, ELLISVILLE, MS 39437(601) 477-3573(601) 477-3572 Get Directions Write a Review

NPPES record last updated: April 27, 2010. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ellisville Drug NPPES

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

ELLISVILLE DRUG (NPI 1396829438) is a healthcare organization registered as a community/retail pharmacy in Ellisville, Mississippi and active in the NPI registry since October 2006. The organization lists Deborah R Keaveny, Contracting Manager, as its authorized official.

NPPES Registry Identity

NPI1396829438
Entity TypeOrganization
Primary Taxonomy3336C0003X
Legal Business NameELLISVILLE DRUG ACQUISITION CO.
Location Address915 HILL STEllisville, MS 39437-2419
Mailing Address803 Highway 71 NMena, AR 71953-4367 · (479) 394-6363 · Fax (479) 394-1046
Phone(601) 477-3573
Fax(601) 477-3572
Organization SubpartNo
Authorized OfficialDeborah R KeavenyContracting Manager · (612) 227-7811
Enumeration DateOctober 25, 2006
Last NPPES UpdateApril 27, 2010
✔ NPI 1396829438 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ 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.
Also ListedPharmacyTaxonomy 333600000X · License 00140011 (MS)
915 HILL ST, Ellisville, MS 39437
Open in Google Maps ↗

Other Names 1

Doing Business AsEllisville Drug

Other Identifiers 3

Other2501218Other Id Number-commercial Number
Medicare NSC4450120001
Medicaid0330711MS

Medical Equipment Supplier Medicare DMEPOS 7

Medicare supplier enrollment and the product categories Ellisville Drug #15828 By Walgreens carries, from the Medicare DMEPOS supplier directory.

Ellisville Drug #15828 By Walgreens

DMEPOS supplier · Ellisville, MSOperated by Walgreen Co
✔

Accepts Medicare assignment

Ellisville Drug #15828 By Walgreens 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)20384867
Medicare Participant SinceMarch 1, 2022
Supplier Location915 Hill StEllisville, MS 39437
Phone(601) 477-3573
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 5

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

WALGREEN CO
Pharmacy
915 HILL ST
ELLISVILLE, MS 39437
Jones County (601) 477-3573
RANDALL LAVELLE CAMP
Pharmacist
915 HILL ST
ELLISVILLE, MS 39437
Jones County (601) 477-3573
WALTON FRANK THERRELL R.PH.
Pharmacist
915 HILL ST
ELLISVILLE, MS 39437
Jones County (601) 477-3573
DR. STACY THERRELL THRASH PHARM,D,
Pharmacist
915 HILL ST
ELLISVILLE, MS 39437
Jones County (601) 545-2056
HALEY HAGAN
Pharmacist
915 HILL ST
ELLISVILLE, MS 39437
Jones County (601) 477-3573

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 Ellisville Drug Acquisition Co.'s NPI number?

The NPI number for Ellisville Drug Acquisition Co. is 1396829438. It was assigned to this organization in the NPPES registry on October 25, 2006. The provider is doing business as Ellisville Drug.

Where is Ellisville Drug Acquisition Co. located?

Ellisville Drug Acquisition Co. is located at 915 Hill St, Ellisville, MS 39437. The listed phone number is (601) 477-3573.

What is Ellisville Drug Acquisition Co.'s specialty?

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

Does Ellisville Drug Acquisition Co. accept Medicare assignment for medical equipment?

Yes. As a Medicare medical equipment supplier, Ellisville Drug #15828 By Walgreens accepts Medicare assignment: the supplier accepts the Medicare-approved amount as payment in full for covered equipment and supplies.

When was this NPI record last updated?

The NPPES record for Ellisville Drug Acquisition Co. was last updated on April 27, 2010. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 16 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.