Walnut Square Pharmacy
LBN: Walnut Square Pharmacy Llc
Walnut Square Pharmacy is an health care organization with primary practice located at 124 Walnut Cir Ste 3, Hattiesburg MS 39401-3500. 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.
Walnut Square Pharmacy Llc can be contacted via phone (601) 543-0111, or through Worrel, Stephen via phone (601) 583-3232.
Contact Information
Primary practice address
124 Walnut Cir Ste 3
Hattiesburg MS 39401-3500
Phone: (601) 543-0111
Fax: (601) 543-0208
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Suppliers / Pharmacy | 333600000X | ||
| Suppliers / Community/Retail Pharmacy | 3336C0003X | 05515011 | Mississippi |
Profile Details
| NPI number | 1578603015 |
|---|---|
| LBN Legal business name | Walnut Square Pharmacy Llc |
| DBA Doing business as | Walnut Square Pharmacy |
| Authorized official | Worrel, Stephen PHARMD |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Feb 7th, 2007 |
| Last updated | Sep 12th, 2007 - about 18 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 | 1578603015 | NPPES |
| Other | 2521082 | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| Other | 2521082 | OTHER ID NUMBER-COMMERCIAL NUMBER | |
| MEDICAID | 0330691 | OTHER ID NUMBER-COMMERCIAL NUMBER |
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