Peace Wellness Center, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

License

R869034 Issued in MS

Legal business name

PEACE WELLNESS CENTER, LLC

Practice address

638 Northwest Ave
Durant, MS 39063-3337

Phone

(601) 842-7107

Fax

(800) 517-7659

NPI assigned

Mar 15, 2012

Last updated

Mar 15, 2012By 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

Mrs. Pamela Jarrett, FNP,BC

Title

Ceo

Phone

(601) 842-7107

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1331769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331769600000",
    "number": "1306111984",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 93",
            "city": "VAIDEN",
            "state": "MS",
            "postal_code": "391760093",
            "telephone_number": "601-842-7107",
            "fax_number": "800-517-7659"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "638 NORTHWEST AVE",
            "city": "DURANT",
            "state": "MS",
            "postal_code": "390633337",
            "telephone_number": "601-842-7107",
            "fax_number": "800-517-7659"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACE WELLNESS CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-15",
        "last_updated": "2012-03-15",
        "status": "A",
        "authorized_official_last_name": "JARRETT",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "601-842-7107",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "FNP,BC"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "MS",
            "license": "R869034",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03607748",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Horace E. Glover Medical Services
• Sharon B Lofton, FNP
• Mallory Community Health
• Mallory Community Health (Dr. Arenia C. Mallory Community Health Center, Inc.)
• Patients Choice Medical Center of Humphreys County, LLC (Patients Choice Clinic of Durant)
• Peace Wellness Mobile Unit
• Tiffany Denice Redd
• Bonita T Roby, LPN
• Daryl Roby, DMD
• Rodgers Medical Clinic

• Clinic/Center in Durant, MS
• Providers in Durant, MS by specialty
• Clinic/Center in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.