Type 2 · Organization ✓ Active NPI ✓ Valid NPI checksum

South Street Pharmacy

Community/Retail Pharmacy in Cleveland, MS · enumerated 2006 · authorized official Michael Clark, Pharmacist Owner.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1306906482

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Registry record

Entity type Organization (Type 2)

Legal business name South Street Pharmacy

Practice address 410 South St, Cleveland, MS, 38732

Phone (662) 843-6700

Enumeration date Dec 11, 2006

Last updated in NPPES Mar 20, 2018

Taxonomy & classification

183500000X Pharmacist Pharmacy Service Providers · License 05857 (MS) Secondary

3336C0003X Community/Retail Pharmacy Suppliers Primary

3336L0003X Long Term Care Pharmacy Suppliers Secondary

Authorized official

Name Michael Clark

Title Pharmacist Owner

Phone (662) 843-6700

Other identifiers

Identifier	Type	State	Issuer
04686806	Medicaid	MS	-
03181784	Medicaid	MS	-
2521513	Other	MS	NABP NUMBER
09058522	Other	MS	MEDICAID DME

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.

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Frequently asked questions

Where is South Street Pharmacy located?

The practice location on file with NPPES is in Cleveland, MS.

How current is this record?

Data comes from the CMS NPPES public dissemination file; this record was last updated in NPPES on 2018-03-20. Verify at npiregistry.cms.hhs.gov.

Providers at this address

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Michael Clark Pharmacist · Cleveland, MS NPI 1174622930

Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2018-03-20.