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Deactivated NPI 1194094367 Deactivated / Inactive NPI Female Practitioner

Aetna Condon Booth , RPH

Pharmacist • Leland, MS

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Aetna Booth has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date December 18, 2011
NPI Deactivation Date April 04, 2017
Total Practice Duration ~6 Years of Practice (2011 – 2017)

Professional Overview & Biography Verified Profile Summary

Aetna Booth, RPH was a registered Pharmacist practicing in Leland, MS. Throughout an active medical career spanning 6 years, Aetna Booth provided care at the practice location at 202 W 2ND ST until profile deactivation on 2017-04-04.

Practice Location & Contact Primary Location

Practice Address

202 W 2nd St

Leland, MS 387562443

Telephone 6626864647

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Leland, MS

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
1 Specialists

Practicing in Leland, MS (2321 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License MS E-02978

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 04, 2017

Record deactivated on April 04, 2017

NPI Profile Active December 18, 2011

NPI status registered as active in NPPES database

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Updated Practice Location December 18, 2011

Registered at 202 W 2ND ST, LELAND, MS 387562443 (Tel: 6626864647)

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Updated Business Mailing Address December 18, 2011

Registered at 202 W 2ND ST, LELAND, MS 387562443 (Tel: 6626864647)

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Provider Name / Credentials Updated December 18, 2011

Recorded as AETNA BOOTH, RPH

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Medical Taxonomy / Specialty Registered (Primary Specialty) December 18, 2011

Pharmacist (License #E-02978 in MS)

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Initial NPI Registration & Enumeration December 18, 2011

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1194094367
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: December 18, 2011
Last Update: December 18, 2011
Deactivation Date: April 04, 2017

Mailing Address

202 W 2nd St

Leland, MS 387562443

Phone: 6626864647

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.