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General NPI Number Information
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NPI Number | 1689039711
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Entity Type | Organization
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Legal Business Name | RIVER REGION HEALTH SYSTEM
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Dates
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Enumeration Date | 12/16/2015
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Last Update Date | 12/16/2015
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Provider Practice Location Address
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Address Line | 2100 HIGHWAY 61 N PHARMACY
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City | VICKSBURG
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State | MS
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Zip | 39183-8211
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Country | US
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Telephone | 601-415-3809
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Fax |
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Provider Business Mailing Address
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Address Line | 118 BRECKENRIDGE DR APT 205
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City | HATTIESBURG
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State | MS
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Zip | 39402-3504
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Country | US
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Telephone | 601-415-3809
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Fax |
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Authorized Official
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Title or Position | VP
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Name | V KAREN FLINN
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Credential |
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Telephone | 361-579-0315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 3336C0002X
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Taxonomy Name | Clinic Pharmacy
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License Number | E-13632
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License Number State | MS
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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 | E-13632
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 3336C0004X
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Taxonomy Name | Compounding Pharmacy
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License Number | E-13632
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License Number State | MS
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Taxonomy #4
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Taxonomy Code | 3336I0012X
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Taxonomy Name | Institutional Pharmacy
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License Number | E-13632
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License Number State | MS
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Taxonomy #5
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Taxonomy Code | 333600000X
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Taxonomy Name | Pharmacy
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License Number | E-13632
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License Number State | MS
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