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Organization

REGION TEN STATE OF MS

Active
Parent organization
REGION TEN STATE OF MISSISSIPPI
Other names
Weems Mental Health
Organization subpart
Yes

Provider details

NPI number
Legal business name
REGION TEN STATE OF MISSISSIPPI
Authorized official
LORI WALTON (BUSINESS OFFICE MANAGER)
(601) 483-4821
Entity
Organization

Contact information

Practice address
1415 COLLEGE DRIVE, MERIDIAN, MS 39307
(601) 483-4821
Mailing address
1415 COLLEGE DRIVE, MERIDIAN, MS 39307
(601) 483-4821

Taxonomy

Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00018210
MS
Enumeration date
08/27/2012
Last updated
03/29/2013
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