OrganizationActive
Thirteenth Avenue Pharmacy
NPI 1255474102 · Community/Retail Pharmacy · Laurel, MS
Provider details
- NPI number
- 1255474102
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Kyle Mauldin, Pharmacist Owener(601) 428-7257
- License
- 01527 01.1 (MS)
Specialties & taxonomies
Suppliers
Profile Score
Detailed profile(89/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
19 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
216 S 13th Ave
Laurel, MS 39440-4226
Phone: (601) 428-7257
Fax: (601) 428-0074
Street-level locationGet directions
Mailing address
216 S 13th Ave
Laurel, MS 39440-4226
Registry dates
- Enumerated
- 2007-02-14
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.