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Organization

ADVANTAGE PHARMACY

Active
Other names
ADVANTAGE PHARMACY
Organization subpart
No

Provider details

NPI number
Authorized official
GLENN BEACH (MANG PARTNER)
(601) 268-1422
Entity
Organization

Contact information

Practice address
6375 U S HIGHWAY 98, SUITE 50, HATTIESBURG, MS 39402-7410
(601) 268-1422
(601) 268-1424
Mailing address
6375 U S HIGHWAY 98, SUITE 50, HATTIESBURG, MS 39402-7410
(601) 268-1422
(601) 268-1424

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
07726011
MS
3336C0004X
Compounding Pharmacy
3336M0002X
Mail Order Pharmacy

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
2047542
PK
Enumeration date
05/16/2008
Last updated
04/07/2014
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