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Freds Westside Pharmacy Inc

Freds Westside Pharmacy Inc is a healthcare organization registered as Community/Retail Pharmacy in Picayune, MS, holding Type 2 (organization) NPI 1265520290 since 2006. The authorized official on file is Roger Cruse, Owner.

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NPI 1265520290
Entity type Organization (Type 2)
Legal business name Freds Westside Pharmacy Inc
Practice address 207 KIRKWOOD ST, Picayune, MS, 39466
Phone 6017988888
Fax 6017991012
Enumeration date 2006-10-11
Last updated in NPPES 2019-08-05

Authorized official

Name Roger Cruse
Title Owner
Phone 6017988888

Taxonomy & classification

Taxonomy code Specialty Primary License State
3336C0003X Community/Retail Pharmacy Primary

Other identifiers

Identifier Type State Issuer
0330105 Medicaid MS
01786239 Other MS MEDICAID DMERC
Copy-ready billing details
Provider: Freds Westside Pharmacy Inc
NPI: 1265520290
Taxonomy: 3336C0003X (Community/Retail Pharmacy)
Address: 207 KIRKWOOD ST, Picayune, MS, 39466

Verify this record

Cross-check NPI 1265520290 against the authoritative CMS record: view Freds Westside Pharmacy Inc on the official NPPES registry .

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.

Frequently asked questions

Where is Freds Westside Pharmacy Inc located?
The practice location on file with NPPES is in Picayune, MS.
How current is this record?
Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2019-08-05. Verify at npiregistry.cms.hhs.gov.

Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2019-08-05.