# SOUTH MISSISSIPPI PHARMACISTS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** Park Place Pharmacy
- **Organization subpart:** No

## Provider details

- **NPI number:** 1336433473
- **Authorized official:** BRENT LINDLEY PHARM.D. (OWNER)
- **Authorized official phone:** (601) 450-3673

## Contact information

- **Practice address:** 46 PARKWAY LN, PETAL, MS 39465-3035
- **Practice address phone:** (601) 450-3673
- **Practice address fax:** (888) 959-2285
- **Mailing address:** 46 PARKWAY LN, PETAL, MS 39465-3035
- **Mailing address phone:** (601) 450-3673
- **Mailing address fax:** (888) 959-2285

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332B00000X | Durable Medical Equipment & Medical Supplies | — | NULL | — |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 090361.1 | MS | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 06/07/2011
- **Last updated:** 07/16/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 07904554 | — | MS |
| 01 | — | 2131489 | PK | — |