Organization
SINGING RIVER MENTAL HEALTH MENTAL RETARDATION SERVICES
Active
Other names
Singing River Services Region XIV
Organization subpart
No
Provider details
NPI number
Authorized official
BRETTA ST ROMAIN (PHARMACIST-IN-CHARGE)
(228) 497-0690
Entity
Organization
Contact information
Practice address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
(228) 497-0794
Mailing address
3407 SHAMROCK CT, GAUTIER, MS 39553-5337
(228) 497-0690
(228) 497-0794
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0002X
Clinic Pharmacy
Primary
14452/5.1
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01832567
—
MS
01
—
2153586
PK
—
Enumeration date
10/23/2014
Last updated
04/28/2016
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