Waveland Pharmacy LLC
NPI 1679507644 · Community/Retail Pharmacy · Waveland, MS
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Waveland Pharmacy LLC is a Community/Retail Pharmacy organization in Waveland, MS (NPI 1679507644).
Provider details
- NPI number
- 1679507644
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Rudy Letellier, Owner Phcst(228) 463-1055
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
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
Mailing address
Other names (DBA / former)
- Doing business as
- Waveland Pharmacy
Registry dates
- Enumerated
- 2006-07-10
- Last updated
- 2015-12-14
Frequently asked questions
- What is Waveland Pharmacy LLC's NPI number?
- Waveland Pharmacy LLC's National Provider Identifier (NPI) is 1679507644, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Waveland Pharmacy LLC?
- Waveland Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Waveland Pharmacy LLC located?
- Waveland Pharmacy LLC's practice location on file with NPPES is 112 Auderer Blvd, Waveland, MS 39576-2432.
- What is Waveland Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Waveland Pharmacy LLC is (228) 463-1055.
- Does Waveland Pharmacy LLC accept Medicare?
- Waveland Pharmacy LLC 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 Waveland Pharmacy LLC?
- The authorized official listed on Waveland Pharmacy LLC's NPPES record is Rudy Letellier, Owner Phcst. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Waveland Pharmacy LLC's NPI active?
- Yes — Waveland Pharmacy LLC's NPI (1679507644) is active in the NPPES registry as of the last update on 2015-12-14.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.