Walnut Square Pharmacy

LBN: Walnut Square Pharmacy Llc
Walnut Square Pharmacy is an health care organization with primary practice located at 124 Walnut Cir Ste 3, Hattiesburg MS 39401-3500. The organization recently has 2 registered licenses in different health care specialties including Suppliers / Pharmacy, Suppliers / Community/Retail Pharmacy. Suppliers / Community/Retail Pharmacy is the primary health care specialty. Walnut Square Pharmacy Llc can be contacted via phone (601) 543-0111, or through Worrel, Stephen via phone (601) 583-3232.

Contact Information

Primary practice address
124 Walnut Cir Ste 3 Hattiesburg MS 39401-3500
Phone: (601) 543-0111
Fax: (601) 543-0208
Website:
Map and Directions
Authorized official contact:
Name: Worrel, Stephen PHARMD
Phone: (601) 583-3232

Health care specialties

SpecialtyCodeLicense #State
Suppliers / Pharmacy 333600000X
Suppliers / Community/Retail Pharmacy 3336C0003X 05515011 Mississippi

Profile Details

NPI number 1578603015
LBN Legal business name Walnut Square Pharmacy Llc
DBA Doing business as Walnut Square Pharmacy
Authorized official Worrel, Stephen PHARMD
Entity Organization
Organization subpart 1 No
Enumeration date Feb 7th, 2007
Last updated Sep 12th, 2007 - about 19 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1578603015 NPPES
Other 2521082 OTHER ID NUMBER-COMMERCIAL NUMBER
Other 2521082 OTHER ID NUMBER-COMMERCIAL NUMBER
MEDICAID 0330691 OTHER ID NUMBER-COMMERCIAL NUMBER

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