Thirteenth Avenue Pharmacy

LBN: Thirteenth Avenue Pharmacy
Thirteenth Avenue Pharmacy is an health care organization with primary practice located at 216 S 13Th Ave , Laurel MS 39440-4226. The organization recently has only one registered license in Suppliers / Community/Retail Pharmacy, which is considered as the primary health care specialty. Thirteenth Avenue Pharmacy can be contacted via phone (601) 428-7257, or through Mauldin, Kyle via phone (601) 428-7257.

Contact Information

Primary practice address
216 S 13Th Ave Laurel MS 39440-4226
Phone: (601) 428-7257
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Mauldin, Kyle R.PH.
Phone: (601) 428-7257

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Community/Retail Pharmacy 3336C0003X 01527 Mississippi

Profile Details

NPI number 1689898579
LBN Legal business name Thirteenth Avenue Pharmacy
DBA Doing business as
Authorized official Mauldin, Kyle R.PH.
Entity Organization
Organization subpart 1 No
Enumeration date Apr 12th, 2007
Last updated Aug 22nd, 2020 - about 4 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 1689898579 NPPES
Mississippi MEDICAID 00330499

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