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
Phone: (601) 544-4871
Fax: (601) 583-2298
Website:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1144383613 | NPPES |
| Other | 2158949 | PK | |
| MEDICAID | 00095079 | PK |
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