SOUTHERN SPECIALTY CLINIC, LLC
NPI 1730903113
Pharmacy in Flowood, MS

Active since November 12, 2024CLIA 25D2314793 · Waiver
803 LIBERTY RD, FLOWOOD, MS 39232(601) 714-1967(601) 714-1966 Get Directions Write a Review

NPPES record last updated: November 12, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Southern Specialty Clinic, Llc NPPES

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

SOUTHERN SPECIALTY CLINIC, LLC (NPI 1730903113), doing business as Southern Specialty Pharmacy, is a healthcare organization registered as a pharmacy in Flowood, Mississippi and active in the NPI registry since November 2024. The organization holds a CLIA Waiver certificate valid through November 26, 2026 and lists Sharon Marie Pennington, Chief Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1730903113
Entity TypeOrganization
Primary Taxonomy333600000X
Legal Business NameSOUTHERN SPECIALTY CLINIC, LLC
Location Address803 LIBERTY RDFlowood, MS 39232-9000
Mailing Address122 Woodlands Glen CirBrandon, MS 39047-7107 · (601) 985-8296
Fax(601) 714-1966
Organization SubpartYes
Authorized OfficialSharon Marie PenningtonChief Executive Officer · (601) 985-8296
Enumeration DateNovember 12, 2024
NPPES CertifiedNovember 12, 2024
NPI 1730903113 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacySuppliers
Taxonomy Code333600000X
Definition

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.

803 LIBERTY RD, Flowood, MS 39232

Other Names 1

Doing Business AsSouthern Specialty Pharmacy

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 25D2314793

Southern Specialty Research LLC · Flowood, MS
Active · expires Nov 26, 2026
CLIA Number25D2314793
Laboratory TypeClinical Research
Certificate Effective DateNovember 27, 2024
Certificate Expiration DateNovember 26, 2026
Laboratory DirectorJennifer Easley
Laboratory Phone(601) 714-1967
Laboratory LocationSouthern Specialty Research LLC803 Liberty Road, Flowood, MS 39232
CLIA data matches this NPI record on: Address Phone
This certificate is issued to a laboratory to perform only waived tests.

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.

Pediatrics (Pediatric Hematology-Oncology)
803 LIBERTY RD
FLOWOOD, MS 39232
Pediatrics (Pediatric Hematology-Oncology)
803 LIBERTY RD
FLOWOOD, MS 39232
Pediatrics
803 LIBERTY RD
FLOWOOD, MS 39232
Nurse Practitioner
803 LIBERTY RD
FLOWOOD, MS 39232

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1730903113, enumerated as an "organization" on November 12, 2024.

The provider is located at 803 LIBERTY RD FLOWOOD, MS 39232 and the phone number is (601) 714-1967.

Pharmacy with taxonomy code 333600000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Ambetter from Absolute. Please consult your insurance carrier or call the provider to verify.