Organization Name: | PIONEER HEALTH SERVICES OF CHOCTAW COUNTY, LLC |
NPI Number: | 1508147216 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JOSEPH S MCNULTY (CEO) |
Mailing Address: | 311 W Cherry St Ackerman |
State: | MS US |
Postal Code: | 397358708 |
Phone Number: | 6622851928 |
Fax Number: | |
NPI Enumeration Date: | 09/08/2011 |
NPI Last Update Date: | 09/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QE0002X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Emergency Care |
Taxonomy Definition: |