Healthcare Provider Details

I. General information

NPI: 1023973294
Provider Name (Legal Business Name): CITY CAREMEDS PHARMACY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2025
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

349 S MAIN ST
PICAYUNE MS
39466-4415
US

IV. Provider business mailing address

349 S MAIN ST
PICAYUNE MS
39466-4415
US

V. Phone/Fax

Practice location:
  • Phone: 601-798-4761
  • Fax: 601-798-4714
Mailing address:
  • Phone: 601-798-4761
  • Fax: 601-798-4714

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336L0003X
TaxonomyLong Term Care Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN FRANCIS PISARICH
Title or Position: OWNER
Credential: PHARM.D.
Phone: 601-798-4761