Mississippi Center For Advanced Medicine
LBN: Mississippi Center For Advanced Medicine Pc
Mississippi Center For Advanced Medicine is an health care organization with primary practice located at 7731 Old Canton Rd Ste B , Madison MS 39110-6115. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Clinic Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty.
Mississippi Center For Advanced Medicine Pc can be contacted via phone (601) 499-0935, or through Sullivan, Spencer via phone (601) 863-9764.
Contact Information
Primary practice address
7731 Old Canton Rd Ste B
Madison MS 39110-6115
Phone: (601) 499-0935
Fax: (601) 499-0936
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Clinic Pharmacy | 3336C0002X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 14837/1.1 | Mississippi |
Profile Details
| NPI number | 1740636786 |
|---|---|
| LBN Legal business name | Mississippi Center For Advanced Medicine Pc |
| DBA Doing business as | Mississippi Center For Advanced Medicine |
| Authorized official | Sullivan, Spencer Doctor of Medicine (MD) |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | May 9th, 2016 |
| Last updated | Oct 5th, 2016 - about 9 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 | 1740636786 | NPPES |
| Other | 2160699 | PK | |
| MEDICAID | 09587750 | PK |
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