Provider Demographics
NPI:1912048646
Name:AMT GROUP LLC
Entity Type:Organization
Organization Name:AMT GROUP LLC
Other - Org Name:HELPING HAND FAMILY PHARMACY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHARMACIST
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:
Authorized Official - Last Name:JONES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-631-6837
Mailing Address - Street 1:1670 HIGHWAY 61 N
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39183-3411
Mailing Address - Country:US
Mailing Address - Phone:601-631-6837
Mailing Address - Fax:601-631-3906
Practice Address - Street 1:1670 HIGHWAY 61 N
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39183-3411
Practice Address - Country:US
Practice Address - Phone:601-631-6837
Practice Address - Fax:601-631-3906
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-08
Last Update Date:2010-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
333600000X
MS057040113336C0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3336C0003XSuppliersPharmacyCommunity/Retail Pharmacy
No333600000XSuppliersPharmacy
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS0330720Medicaid
2521284OtherNCPDP PROVIDER IDENTIFICATION NUMBER