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UNIVERSITY OF SOUTHERN MISSISSIPPI NPI 1750402798


NPI Information

NPI: 1750402798
Provider Name: UNIVERSITY OF SOUTHERN MISSISSIPPI

Doing Business As: B EMMELINE SMITH CLINIC

Classification: Pharmacy - 3336C0002X
Entity Type: Organization

Specialization: Clinic Pharmacy

CLIA Number: 25D2189870

Address:
118 COLLEGE DR
STE 5066
HATTIESBURG, MS
ZIP 39406
Phone: (601) 266-4075
Get Directions

UNIVERSITY OF SOUTHERN MISSISSIPPI is a clinic pharmacy pharmacy in Hattiesburg, MS. The provider is a pharmacy in a clinic, emergency room or hospital (outpatient) that dispenses medications to patients for self-administration under the supervision of a pharmacist. UNIVERSITY OF SOUTHERN MISSISSIPPI NPI is 1750402798. The provider is registered as an organization entity type.
The provider Is Doing Business As B Emmeline Smith Clinic.

The provider's business location address is:

118 COLLEGE DR
STE 5066
HATTIESBURG, MS
ZIP 39406-002
Phone: (601) 266-4075
Fax: (601) 266-4205

The provider's authorized official is Celeste Tisdale .
The authorized official title is Phcy Mngr and has the following contact phone number (601) 266-4075.

The CLIA number assigned to this NPI record is 25D2189870 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/3/2007 and was last updated on 7/14/2010.


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
13336C0002XPharmacyClinic Pharmacy01065MISSISSIPPIYes

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
12518491OTHERNCPDP PROVIDER IDENTIFICATION NUMBER

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

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