# SINGING RIVER GULFPORT

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- **Entity:** Organization
- **Status:** Active
- **Other names:** The Pharmacy at Singing River Gulfport
- **Organization subpart:** No

## Provider details

- **NPI number:** 1972247658
- **Authorized official:** LISA FRATESI (PHARMACY DIRECTOR)
- **Authorized official phone:** (228) 818-2109

## Contact information

- **Practice address:** 15200 COMMUNITY RD, GULFPORT, MS 39503-3085
- **Practice address phone:** (228) 575-7365
- **Practice address fax:** (228) 575-7368
- **Mailing address:** 2101 HIGHWAY 90, GAUTIER, MS 39553-5340
- **Mailing address phone:** (228) 497-7576
- **Mailing address fax:** (228) 497-8869

## Taxonomy

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

## Other

- **Enumeration date:** 04/27/2022
- **Last updated:** 06/14/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 2593540 | NCPDP | MS |