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General NPI Number Information
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NPI Number | 1194850917
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Entity Type | Organization
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Legal Business Name | NORTH MISSISSIPPI STATE HOSPITAL PHARMACY
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Dates
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Enumeration Date | 02/22/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1937 BRIAR RIDGE RD
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City | TUPELO
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State | MS
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Zip | 38804-5963
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Country | US
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Telephone | 662-690-4301
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Fax | 662-690-5730
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Provider Business Mailing Address
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Address Line | 1937 BRIAR RIDGE RD
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City | TUPELO
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State | MS
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Zip | 38804-5963
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Country | US
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Telephone | 662-690-4301
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Fax | 662-690-5730
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Authorized Official
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Title or Position | DIRECTOR OF PHARMACY
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Name | DR. ERIC PITTMAN
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Credential | PHARMD
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Telephone | 662-690-4301
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | 04542
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License Number State | MS
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