Lifecore Pharmacy Tupelo

LBN: Northeast Mental Health-Mental Retardation Commission
Lifecore Pharmacy Tupelo is an health care organization with primary practice located at 499 Gloster Creek Vlg Ste A3 , Tupelo MS 38801-4600. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Northeast Mental Health-Mental Retardation Commission can be contacted via phone (662) 912-5006, or through Watson, Van via phone (662) 912-5006.

Contact Information

Primary practice address
499 Gloster Creek Vlg Ste A3 Tupelo MS 38801-4600
Fax: (662) 680-5125
Website:
Authorized official contact:
Name: Watson, Van BS PHARMACY

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 12959/5.1 Mississippi

Profile Details

NPI number 1427489517
LBN Legal business name Northeast Mental Health-Mental Retardation Commission
DBA Doing business as Lifecore Pharmacy Tupelo
Authorized official Watson, Van BS PHARMACY
Entity Organization
Organization subpart 1 No
Enumeration date Nov 27th, 2013
Last updated Apr 19th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427489517 NPPES
Mississippi MEDICAID 07371351
Mississippi Other 2143598

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