Independent Healthcare Management, Inc.
Organization Active NPI Rural Health Clinic/Center · Forest, MS
NPI 1245489186 · NPPES record last updated Jun 22, 2015
Key facts
- NPI
- 1245489186
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- INDEPENDENT HEALTHCARE MANAGEMENT, INC.
- Practice address
- 526 Deerfield Dr
Suite C
Forest, MS 39074-6005 - Phone
- (601) 469-0291
- Fax
- (601) 469-0347
- NPI assigned
- Sep 16, 2008
- Organization subpart
- No
Authorized official
- Name
- Mr. Joseph S McNulty III
- Title
- Owner/Ceo
- Phone
- (601) 849-6440
Other NPIs on the same Medicare enrollment 13
Practitioners 3
-
Ruth C Gaddis, FNP
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031215000487 | MS | Part B Supplier - Clinic/Group Practice | 0840197232 |
Receives reassigned benefits from 95 practitioners 13 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Raleigh, MS; Newton, MS; Morton, MS; Magee, MS; Forest, MS |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
526 Deerfield Dr
Suite C
Forest, MS 39074-6005
Mailing address
PO Box 1100
Magee, MS 39111-1100
Phone (601) 849-6440
Other names
- Total Care Clinic
Other providers in Forest, MS
- Independent Healthcare Management, Inc
- Independent Healthcare Management, Inc
- Independent Healthcare Management, Inc,
- Independent Healthcare Management, Inc.
- Independent Healthcare Management, Inc.
- Independent Healthcare Management, Inc.
- Independent Healthcare Management, Inc.
- Independent Healthcare Management, Inc.
- Independent Healthcare Management, Inc.
- Independent Healthcare Management, Inc.
All providers in Forest, MS · Rural Health Clinic/Center in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.