Praetorian Health Services, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

PRAETORIAN HEALTH SERVICES, LLC

Practice address

10241 Boney Ave
Suite a
Diberville, MS 39540-4889

Phone

(228) 314-1290

NPI assigned

Jan 20, 2015

Organization subpart

No

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

Authorized official

Name

Melanie Fayard

Title

Owner

Phone

(228) 596-5719

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1421712000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1471564800000",
    "number": "1447649009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7066",
            "city": "GULFPORT",
            "state": "MS",
            "postal_code": "395067066",
            "telephone_number": "228-314-1290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10241 BONEY AVE",
            "address_2": "SUITE A",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395404889",
            "telephone_number": "228-314-1290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRAETORIAN HEALTH SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-20",
        "last_updated": "2016-08-19",
        "status": "A",
        "authorized_official_last_name": "FAYARD",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "228-596-5719"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Diem Hong Phan, PHARM D
• Bridget D Piernas, BEHAVIOR TECHNITIAN
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• Latoya Carson Plummer, PT, DPT
• Courtney Leigh Ponder, APRN
• Stacy Ragno, COTA/L
• Rampdr
• Timothy C Reid, LCSW
• Resolute Healthcare
• Diasha Robertson

• In Home Supportive Care Agency in Diberville, MS
• Providers in Diberville, MS by specialty
• In Home Supportive Care Agency in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2016; 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.