Liberty Drug Store, Inc.
NPI 1639124183 · Pharmacist · Liberty, MS
Enrolled with Medicare as Dme Supplier - Pharmacy · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Liberty Drug Store, Inc. is a Pharmacist organization in Liberty, MS (NPI 1639124183).
Provider details
- NPI number
- 1639124183
- Entity type
- Organization
- Primary specialty
- PharmacistPharmacy Service Providers
- Organization subpart
- No
- Authorized official
- Ronald Blalock, President/Pharmacist(601) 657-8051
- License
- T08879 (MS)
Specialties & taxonomies
Pharmacy Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 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
Registry dates
- Enumerated
- 2006-05-23
- Last updated
- 2023-12-07
- Certified
- 2023-12-07
Frequently asked questions
- What is Liberty Drug Store, Inc.'s NPI number?
- Liberty Drug Store, Inc.'s National Provider Identifier (NPI) is 1639124183, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Liberty Drug Store, Inc.?
- Liberty Drug Store, Inc. is classified in the NPPES registry as Pharmacist (Pharmacy Service Providers).
- Where is Liberty Drug Store, Inc. located?
- Liberty Drug Store, Inc.'s practice location on file with NPPES is 110 E Main St, Liberty, MS 39645.
- What is Liberty Drug Store, Inc.'s phone number?
- The practice phone number listed in the NPPES registry for Liberty Drug Store, Inc. is (601) 657-8051.
- Does Liberty Drug Store, Inc. accept Medicare?
- Liberty Drug Store, Inc. is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Liberty Drug Store, Inc.?
- The authorized official listed on Liberty Drug Store, Inc.'s NPPES record is Ronald Blalock, President/Pharmacist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Liberty Drug Store, Inc.'s NPI active?
- Yes — Liberty Drug Store, Inc.'s NPI (1639124183) is active in the NPPES registry as of the last update on 2023-12-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.