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REGION 12 COMMISSION ON MENTAL HEALTH & RETARDATION PINE NPI 1861645657


NPI Information

NPI: 1861645657
Provider Name: REGION 12 COMMISSION ON MENTAL HEALTH & RETARDATION PINE

Doing Business As: PINE BELT MENTAL HEALTHCARE RESOURCES

Classification: Pharmacy - 3336C0003X
Entity Type: Organization

Specialization: Community/Retail Pharmacy

Address:
103 S 19TH AVE
HATTIESBURG, MS
ZIP 39401
Phone: (601) 544-4641
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REGION 12 COMMISSION ON MENTAL HEALTH & RETARDATION PINE is a community/retail pharmacy pharmacy in Hattiesburg, MS. The provider is a pharmacy where pharmacists store, prepare, and dispense medicinal preparations and/or prescriptions for a local patient population in accordance with federal and state law; counsel patients and caregivers (sometimes independent of the dispensing process); administer vaccinations; and provide other professional services associated with pharmaceutical care such as health screenings, consultative services with other health care providers, collaborative practice, disease state management, and education classes. REGION 12 COMMISSION ON MENTAL HEALTH & RETARDATION PINE NPI is 1861645657. The provider is registered as an organization entity type.
The provider Is Doing Business As Pine Belt Mental Healthcare Resources.

The provider's business location address is:

103 S 19TH AVE
HATTIESBURG, MS
ZIP 39401-171
Phone: (601) 544-4641
Fax: (601) 450-4632

The provider's authorized official is Jerry Mayo .
The authorized official title is Ceo and has the following contact phone number (601) 544-4641.

The enumeration date for this NPI number is 10/24/2008 and was last updated on 2/16/2017.


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
1333600000XPharmacyNo
23336C0003XPharmacyCommunity/Retail Pharmacy07864/5.1MISSISSIPPIYes

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
12117558OTHERPK

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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