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HATTIESBURG CONVALESCENT HOME INC. NPI 1366584708


NPI Information

NPI: 1366584708
Provider Name: HATTIESBURG CONVALESCENT HOME, INC.

Other Name: HATTIESBURG CONVALESCENT CENTER

Classification: Pharmacist - 183500000X
Entity Type: Organization
Address:
514 BAY ST
HATTIESBURG, MS
ZIP 39401
Phone: (601) 544-4230
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HATTIESBURG CONVALESCENT HOME, INC. is a pharmacist in Hattiesburg, MS. The provider is 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. HATTIESBURG CONVALESCENT HOME, INC. NPI is 1366584708. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Other Name Is Hattiesburg Convalescent Center.

The provider's business location address is:

514 BAY ST
HATTIESBURG, MS
ZIP 39401-933
Phone: (601) 544-4230
Fax: (601) 582-2480

The provider's authorized official is Jewell C Mcmahan .
The authorized official title is Administrator and has the following contact phone number (601) 544-4230.

The enumeration date for this NPI number is 2/13/2007 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1183500000XPharmacist0017704.1MISSISSIPPIYes
2314000000XSkilled Nursing Facility25MISSISSIPPIX

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
10023061MEDICAIDMISSISSIPPI
200036421MEDICAIDMISSISSIPPI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.