Precision Life Sciences LLC

Primary specialty

Clinical Medical LaboratoryTaxonomy code 291U00000X

Legal business name

PRECISION LIFE SCIENCES LLC

Practice address

4850 Goodman Rd Ste 101
Olive Branch, MS 38654-7906

Phone

(615) 556-6628

NPI assigned

Aug 31, 2021

Last updated

May 19, 2022By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Andrew Wiseman

Title

Ceo

Phone

(615) 556-6628

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MS

Enrollment records 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1630368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1652918400000",
    "number": "1083382592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4850 GOODMAN RD STE 101",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547906",
            "telephone_number": "615-556-6628"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4850 GOODMAN RD STE 101",
            "city": "OLIVE BRANCH",
            "state": "MS",
            "postal_code": "386547906",
            "telephone_number": "615-556-6628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRECISION LIFE SCIENCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-08-31",
        "last_updated": "2022-05-19",
        "certification_date": "2022-05-19",
        "status": "A",
        "authorized_official_last_name": "WISEMAN",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "615-556-6628",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Play Fabulous
• Dalton C Plumlee, DMD
• Darla Poole, P-LPC, NCC, CCC
• Marina Lynn Potts, PT, DPT
• Precision Genomics LLC
• Prime Foot Care, PLLC (Desoto Foot Care)
• Dovie Christine Pryor, RNFA
• Pure Light Psychiatry LLC
• Tina Puthalon Kunnath, MD
• Ginger Raff

• Clinical Medical Laboratory in Olive Branch, MS
• Providers in Olive Branch, MS by specialty
• Clinical Medical Laboratory in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.