Fairview Pharmacy & Compounding

LBN: Pomank Ventures Llc
Fairview Pharmacy & Compounding is an health care organization with primary practice located at 500 Katie Ave , Hattiesburg MS 39401-4380. The organization recently has 3 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy, Suppliers / Compounding Pharmacy. Suppliers / Pharmacy is the primary health care specialty. Pomank Ventures Llc can be contacted via phone (601) 544-4871, or through Barnett, Gladys via phone (601) 544-4871.

Contact Information

Primary practice address
500 Katie Ave Hattiesburg MS 39401-4380
Fax: (601) 583-2298
Website:
Authorized official contact:
Name: Barnett, Gladys

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X 01066/1.1 Mississippi
Suppliers / Community/Retail Pharmacy 3336C0003X
Suppliers / Compounding Pharmacy 3336C0004X

Profile Details

NPI number 1144383613
LBN Legal business name Pomank Ventures Llc
DBA Doing business as Fairview Pharmacy & Compounding
Authorized official Barnett, Gladys
Entity Organization
Organization subpart 1 No
Enumeration date Dec 18th, 2006
Last updated Jun 16th, 2016 - 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 1144383613 NPPES
Other 2158949 PK
MEDICAID 00095079 PK

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