OrganizationActive
Region 12 Commission on Mental Health & Retardation Pine
NPI 1861645657 · Community/Retail Pharmacy · Hattiesburg, MS
Provider details
- NPI number
- 1861645657
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Jerry Mayo, Ceo(601) 544-4641
Specialties & taxonomies
Suppliers
- Pharmacy333600000X
Suppliers
Profile Score
Detailed profile(86/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
17 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
103 S 19th Ave
Hattiesburg, MS 39401-6171
Phone: (601) 544-4641
Fax: (601) 450-4632
Street-level locationGet directions
Mailing address
103 S 19th Ave
Hattiesburg, MS 39401-6171
Other names (DBA / former)
- Doing business as
- Pine Belt Mental Healthcare Resources
Registry dates
- Enumerated
- 2008-10-24
- Last updated
- 2017-02-16
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.