# NEWSOUTH NEUROSPINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Advanced RX Pharmacy 024
- **Organization subpart:** No

## Provider details

- **NPI number:** 1538597554
- **Authorized official:** CHRISTINA HANSEN PHARMD (PHARMACIST IN CHARGE)
- **Authorized official phone:** (601) 420-1950

## Contact information

- **Practice address:** 2470 FLOWOOD DR, FLOWOOD, MS 39232-9019
- **Practice address phone:** (601) 983-2840
- **Practice address fax:** (601) 983-2845
- **Mailing address:** 2470 FLOWOOD DR, FLOWOOD, MS 39232-9019
- **Mailing address phone:** (601) 420-1950
- **Mailing address fax:** (601) 420-1951

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 3336C0003X | Community/Retail Pharmacy | 1270111 | MS | Yes |
| 3336C0004X | Compounding Pharmacy | — | NULL | — |

## Other

- **Enumeration date:** 10/30/2013
- **Last updated:** 10/29/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 05430554 | — | MS |
| 01 | — | 2142793 | PK | — |