# MOM 2 BE, LLC

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

## Provider details

- **NPI number:** 1952783078
- **Authorized official:** DR. PAMELA RENEE LACY M.D. (OWNER)
- **Authorized official phone:** (662) 570-4991

## Contact information

- **Practice address:** 449 WILKINS WISE RD, COLUMBUS, MS 39705-1756
- **Practice address phone:** (662) 570-4991
- **Practice address fax:** (662) 570-4992
- **Mailing address:** 449 WILKINS WISE RD, COLUMBUS, MS 39705-1756
- **Mailing address phone:** (662) 570-4991
- **Mailing address fax:** (662) 570-4992

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 332900000X | Non-Pharmacy Dispensing Site | — | NULL | Yes |

## Other

- **Enumeration date:** 06/25/2015
- **Last updated:** 06/25/2015