OrganizationAdvantage PharmacyPharmacySuppliersPractice Address6375 U S Highway 98, Suite 50, Hattiesburg, MS 39402-7410(601) 268-1422PECOS EnrollmentBased on the most recent information from CMS, provider Advantage Pharmacy does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1629235882Provider TypeOrganizationFull NameAdvantage PharmacySubpartNoEnumeration Date5/16/2008Last Updated4/7/2014Contact InformationPractice LocationPractice Address6375 U S Highway 98, Suite 50, Hattiesburg, MS 39402-7410Phone(601) 268-1422Fax(601) 268-1424Mailing LocationMailing Address6375 U S Highway 98, Suite 50, Hattiesburg, MS 39402-7410Phone(601) 268-1422Fax(601) 268-1424Authorized OfficialNameBeach, Glenn (Mang Partner)Phone(601) 268-1422Provider TaxonomiesCodeDescriptionLicenseCode3336C0003XPrimaryDescriptionPharmacySuppliersLicense07726011MississippiCode3336C0004XDescriptionPharmacySuppliersLicenseUnlisted IssuerCode3336M0002XDescriptionPharmacySuppliersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID2047542DescriptionOtherIssuerPK