National Provider Identifier Database

ECONOMIC STIMULUS ACT STUDENT LOAN REFUND 1200 DOLLARS
Pharmacy

A facility used by pharmacists for the compounding and dispensing of medicinal preparations and other associated professional and administrative services. A pharmacy is a facility whose primary function is to store, prepare and legally dispense prescription drugs under the professional supervision of a licensed pharmacist. It meets any licensing or certification standards set forth by the jurisdiction where it is located.


Contact Information

ECONOMIC STIMULUS ACT STUDENT LOAN REFUND 1200 DOLLARS
5001 HARDY ST STE 8
HATTIESBURG, MS39402-1308
Phone: 601-307-5339
Fax:
Website:
Specialty Taxonomy Code
* Pharmacy 333600000X
Clinic/Center 261Q00000X
Genetics 261QG0250X
Physiological Laboratory, (Independent Physiological Lab) 293D00000X
Student Health 261QS1000X

* Indicates primary specialty

NPI Profile & details for ECONOMIC STIMULUS ACT STUDENT LOAN REFUND 1200 DOLLARS

NPI Number 1255999835
Legal business name
LBN
ECONOMIC STIMULUS ACT STUDENT LOAN REFUND 1200 DOLLARS
Authorized official JACOB PARKER - (SPECIALIST TECHNOLOGIST)
Entity Organization
Organization subpart Yes
Enumeration date 05/30/2019
Last updated 09/30/2020 - About 6 years ago
Sole proprietor1 Not specified
Identifiers
  • MS Medicaid: 587539997

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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