Owl Drug Store
LBN: Hattiesburg Clinic Pa
Owl Drug Store is an health care organization with primary practice located at Medical Blvd Ste 2, Hattiesburg MS 39401. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Long Term Care Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Hattiesburg Clinic Pa can be contacted via phone (601) 268-5740, or through Ashley, Diane via phone (601) 268-2740.
Contact Information
Primary practice address
Medical Blvd Ste 2
Hattiesburg MS 39401
Phone: (601) 268-5740
Fax: (601) 268-5858
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 01821/1.1 | Mississippi |
| Suppliers / Long Term Care Pharmacy | 3336L0003X |
Profile Details
| NPI number | 1407861016 |
|---|---|
| LBN Legal business name | Hattiesburg Clinic Pa |
| DBA Doing business as | Owl Drug Store |
| Authorized official | Ashley, Diane RPH |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Jul 30th, 2006 |
| Last updated | Feb 21st, 2017 - about 8 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407861016 | NPPES |
| Other | 2045095 | PK | |
| MEDICAID | 00030291 | PK |
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