# BRENTS DRUGS OF BELHAVEN

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1861564486
- **Authorized official:** RANDY CALVERT (PRES)
- **Authorized official phone:** (601) 355-5114

## Contact information

- **Practice address:** 902B E FORTIFICATION ST, JACKSON, MS 39202
- **Practice address phone:** (601) 355-5114
- **Practice address fax:** (601) 352-9282
- **Mailing address:** 902B E FORTIFICATION ST, JACKSON, MS 39202

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 333600000X | Pharmacy | — | NULL | — |
| 3336C0003X | Community/Retail Pharmacy | 06747 | MS | Yes |

## Other

- **Enumeration date:** 11/15/2006
- **Last updated:** 07/20/2007

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 0033061 | — | MS |
| 01 | — | 2586292 | OTHER ID NUMBER | — |