Picayune Clinic Llc is a Rural in Picayune, Mississippi. Picayune Clinic Llc practices all healthcare services and medical treatments related to Rural. The NPI Number for Picayune Clinic Llc is 1578564712. The last update date is 2020-08-22.
Picayune Clinic Llc's current location address is 801 Goodyear Blvd, Picayune, Mississippi. You can contact this provider via phone number 6017984711 and fax number 6017493187. The mailing address for Picayune Clinic Llc is 801 Goodyear Blvd, Picayune, Mississippi. To know further, please read the information below!
Provider Profile Detail
Provider Organization | Picayune Clinic Llc |
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Address | 801 Goodyear Blvd, Picayune, Mississippi |
Phone Number | 6017984711 |
Fax Number | 6017493187 |
Sole Proprietor | -- |
Credentials | -- |
Authorized Official
Title or Position | CEO |
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Authorized Official Name | Grimm Steve |
Telephone Number | 6017984711 |
NPI Number Detail
NPI Number | 1578564712 |
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Provider Enumeration Date | 2005-08-10 |
Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
Address | 801 Goodyear Blvd |
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City | Picayune |
State | Mississippi (MS) |
Post Code | 394663221 |
Phone Number | 6017984711 |
Fax Number | 6017493187 |
Provider's Primary Taxonomy Detail
Speciality | Rural |
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Taxonomy | 282Nr1301X |
Licence No | 12086 |
Definition: Provides comprehensive inpatient medical and surgical care in rural areas. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
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220682 | MS | -- |
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What is the unique 10-digit identifier code assigned to Picayune Clinic Llc by the Centers for Medicare & Medicaid Services?
The Picayune Clinic Llc has been issued the NPI (National Provider Identifier) 1578564712 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you provide the complete physical address where Picayune Clinic Llc is located?
The Picayune Clinic Llc is situated at the following address: 801 Goodyear Blvd, Picayune, MS, 394663221.
What is Picayune Clinic Llc's area of specialization, and what is the corresponding taxonomy classification code for this field of practice?
The specialized area of practice for Picayune Clinic Llc is Rural, and the taxonomy code that categorizes this field of expertise is 282Nr1301X.
On what date did the Centers for Medicare & Medicaid Services issue the 1578564712 to Picayune Clinic Llc?
The Picayune Clinic Llc received its 1578564712 assignment from the Centers for Medicare & Medicaid Services on 2005-08-10.
When was the information regarding Picayune Clinic Llc, such as address, specialty, and other details, most recently verified or confirmed to be accurate?
The information pertaining to Picayune Clinic Llc, including its address, specialty, and other relevant details, was most recently verified or confirmed to be accurate on 2020-08-22.