Organization
SOUTH MISSISSIPPI REGIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LIONEL HEIDINGSFELDER RPH (PHARMACIST)
(228) 867-1331
Entity
Organization
Contact information
Practice address
1170 W RAILROAD ST, LONG BEACH, MS 39560-4106
(228) 867-1331
(228) 867-1459
Mailing address
1170 W RAILROAD ST, LONG BEACH, MS 39560-4106
Taxonomy
Speciality
Code
Description
License number
State
3336L0003X
Long Term Care Pharmacy
Primary
01345041
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00095206
—
MS
01
—
2518287
OTHER ID NUMBER-COMMERCIAL NUMBER
—
Enumeration date
07/25/2006
Last updated
08/22/2020
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