# CCMS PHARMACY LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1518824739
- **Authorized official:** SAMUEL MAHFOUZ (MANAGER)
- **Authorized official phone:** (318) 443-9195

## Contact information

- **Practice address:** 110 METROPLEX BLVD STE H, PEARL, MS 39208-9210
- **Practice address phone:** (601) 664-1664
- **Practice address fax:** (601) 664-1661
- **Mailing address:** 1412 CENTRE CT STE 503, ALEXANDRIA, LA 71301-3400
- **Mailing address phone:** (318) 443-9195
- **Mailing address fax:** (318) 698-0007

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336L0003X | Long Term Care Pharmacy | — | NULL | Yes |

## Other

- **Enumeration date:** 01/08/2026
- **Last updated:** 01/08/2026