Diamondhead Health Mart Pharmacy,llc
NPI 1003207895 · Community/Retail Pharmacy · Diamondhead, MS
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Provider details
- NPI number
- 1003207895
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Rudy Letellier, Owner/Pharmacist(228) 222-4662
- License
- 14221/1.1 (MS)
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
11 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Diamondhead Health Mart Pharmacy
- Doing business as
- Pharmacy in Diamondhead
Registry dates
- Enumerated
- 2015-02-15
- Last updated
- 2021-11-30
- Certified
- 2021-11-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.