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General NPI Number Information
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NPI Number | 1457638082
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Entity Type | Organization
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Legal Business Name | SINGING RIVER HEALTH SYSTEM
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Dates
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Enumeration Date | 11/10/2011
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Last Update Date | 10/01/2014
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Provider Practice Location Address
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Address Line | 3109 BIENVILLE BLVD
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564-4361
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Country | US
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Telephone | 228-818-3125
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Fax | 228-818-3130
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Provider Business Mailing Address
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Address Line | OCEAN SPRINGS HOSPITAL-PHARMACY 3109 BIENVILLE AVE.
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City | OCEAN SPRINGS
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State | MS
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Zip | 39564
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Country | US
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Telephone | 228-818-1155
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Fax | 228-818-2197
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Authorized Official
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Title or Position | SYSTEM DIRECTOR OF PHARMACY SE
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Name | MADELLINE COLLAZO
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Credential |
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Telephone | 228-818-2109
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 3336C0003X
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Taxonomy Name | Community/Retail Pharmacy
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License Number | 09222/ 1.1
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License Number State | MS
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