| NPI | 1235611765 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTEN PHIPPS Pharmacist 601-765-0403 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Additional Taxonomies | 3336I0012X Pharmacy, Institutional Pharmacy |
| Enumeration Date | 2018-08-31 |
| Last Update Date | 2022-11-10 |