Pine Belt Mental Healthcare Resources

LBN: Region 12 Commission On Mental Health & Retardation Pine
Pine Belt Mental Healthcare Resources is an health care organization with primary practice located at 103 S 19Th Ave , Hattiesburg MS 39401-6171. 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. Region 12 Commission On Mental Health & Retardation Pine can be contacted via phone (601) 544-4641, or through Mayo, Jerry via phone (601) 544-4641.

Contact Information

Primary practice address
103 S 19Th Ave Hattiesburg MS 39401-6171
Phone: (601) 544-4641
Fax: (601) 450-4632
Website:
Map and Directions
Authorized official contact:
Name: Mayo, Jerry
Phone: (601) 544-4641

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 07864/5.1 Mississippi

Profile Details

NPI number 1861645657
LBN Legal business name Region 12 Commission On Mental Health & Retardation Pine
DBA Doing business as Pine Belt Mental Healthcare Resources
Authorized official Mayo, Jerry
Entity Organization
Organization subpart 1 No
Enumeration date Oct 24th, 2008
Last updated Feb 16th, 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 1861645657 NPPES
Other 2117558 PK

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