=====================================================
General NPI Number Information
=====================================================
NPI Number | 1417169186
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HEALTH SERVICES IN ACTION INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2007
-----------------------------------------------------
Last Update Date | 08/22/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 205 S. COMMERCE COVE
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-234-1374
-----------------------------------------------------
Fax | 662-234-1305
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 205 S. COMMERCE COVE
-----------------------------------------------------
City | OXFORD
-----------------------------------------------------
State | MS
-----------------------------------------------------
Zip | 38655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 662-234-1374
-----------------------------------------------------
Fax | 662-234-1305
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | CLINIC PHARMACIST
-----------------------------------------------------
Name | MR. BRENT SMITH
-----------------------------------------------------
Credential | PHARMACIST
-----------------------------------------------------
Telephone | 662-234-1374
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 261QP2300X
-----------------------------------------------------
Taxonomy Name | Primary Care Clinic/Center
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------