Provider Demographics
NPI:1851938898
Name:SINGING RIVER HEALTH SYSTEM
Entity Type:Organization
Organization Name:SINGING RIVER HEALTH SYSTEM
Other - Org Name:SINGING RIVER SPECIALTY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SYSTEM DIRECTOR OF PHARMACY
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:D
Authorized Official - Last Name:FRATESI
Authorized Official - Suffix:
Authorized Official - Credentials:RPH
Authorized Official - Phone:228-818-2109
Mailing Address - Street 1:2809 DENNY AVE
Mailing Address - Street 2:
Mailing Address - City:PASCAGOULA
Mailing Address - State:MS
Mailing Address - Zip Code:39581-5301
Mailing Address - Country:US
Mailing Address - Phone:228-809-2230
Mailing Address - Fax:228-809-2235
Practice Address - Street 1:2809 DENNY AVE
Practice Address - Street 2:
Practice Address - City:PASCAGOULA
Practice Address - State:MS
Practice Address - Zip Code:39581-5301
Practice Address - Country:US
Practice Address - Phone:228-809-2230
Practice Address - Fax:228-809-2235
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:SINGING RIVER HEALTH SYSTEM
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2019-12-10
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No3336S0011XSuppliersPharmacySpecialty Pharmacy