NPIMap

Organization Active NPI

Singing River Mental Health Mental Retardation Services

Doing business as Singing River Services Region XIV

  • Clinic Pharmacy
  • Gautier, MS
National Provider Identifier
1265837983
Registry record updated Apr 28, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic PharmacyTaxonomy code 3336C0002X
License
14452/5.1 Issued in MS
Legal business name
SINGING RIVER MENTAL HEALTH MENTAL RETARDATION SERVICES
Doing business as
Singing River Services Region XIV
Practice address
3407 Shamrock CT
Gautier, MS 39553-5337
Phone
(228) 497-0690
Fax
(228) 497-0794
NPI assigned
Oct 23, 2014
Last updated
Apr 28, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Bretta St Romain
Title
Pharmacist-in-Charge
Phone
(228) 497-0690

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X NU
Clinic Pharmacy 3336C0002X 14452/5.1 MS Primary

Addresses

Primary practice location

3407 Shamrock CT
Gautier, MS 39553-5337

Mailing address

3407 Shamrock CT
Gautier, MS 39553-5337
Phone (228) 497-0690

Other identifiers 2

IdentifierTypeStateIssuer
2153586OtherPK
01832567MedicaidMS

Other names 1

  • Singing River Services Region XIV Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Singing River Mental Health Mental Retardation Services4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1414022400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1461801600000",
    "number": "1265837983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3407 SHAMROCK CT",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535337",
            "telephone_number": "228-497-0690",
            "fax_number": "228-497-0794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3407 SHAMROCK CT",
            "city": "GAUTIER",
            "state": "MS",
            "postal_code": "395535337",
            "telephone_number": "228-497-0690",
            "fax_number": "228-497-0794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SINGING RIVER MENTAL HEALTH MENTAL RETARDATION SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-23",
        "last_updated": "2016-04-28",
        "status": "A",
        "authorized_official_last_name": "ST ROMAIN",
        "authorized_official_first_name": "BRETTA",
        "authorized_official_title_or_position": "PHARMACIST-IN-CHARGE",
        "authorized_official_telephone_number": "228-497-0690"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Clinic Pharmacy",
            "state": "MS",
            "license": "14452/5.1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2153586",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01832567",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Singing River Services Region XIV",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Gautier, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.