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Organization
NEWSOUTH NEUROSPINE LLC
Active
Organization
NEWSOUTH NEUROSPINE LLC
Active
Other names
Advanced RX Pharmacy 024
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINA HANSEN PHARMD (PHARMACIST IN CHARGE)
(601) 420-1950
Entity
Organization
Contact information
Practice address
2470 FLOWOOD DR, FLOWOOD, MS 39232-9019
(601) 983-2840
(601) 983-2845
Mailing address
2470 FLOWOOD DR, FLOWOOD, MS 39232-9019
(601) 420-1950
(601) 420-1951
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
1270111
MS
3336C0004X
Compounding Pharmacy
—
NULL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05430554
—
MS
01
—
2142793
PK
—
Enumeration date
10/30/2013
Last updated
10/29/2020
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