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E D Medical Care

Organization Active NPI Point of Service · Hernando, MS

NPI 1609934272 · NPPES record last updated Aug 22, 2020

Key facts

NPI
1609934272
Entity type
Organization (NPI type 2)
Primary specialty
Point of Service 305S00000X
License
M14539 (MS)
Legal business name
E D MEDICAL CARE
Practice address
2007 Oak Tree CV
Suite 101
Hernando, MS 38632-1198
Phone
(662) 429-8802
Fax
(662) 429-8698
NPI assigned
Dec 5, 2006
Organization subpart
No

Authorized official

Name
Sandra M Jones
Title
Office Manager
Phone
(662) 429-8802

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

2007 Oak Tree Cv
#201
Hernando, MS 38632
Phone (662) 429-8802

2007 Oak Tree Cv
#101
Hernando, MS 38632
Phone (662) 429-8802

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Point of Service 305S00000X M14539 MS Yes

Addresses

Primary practice location

2007 Oak Tree CV
Suite 101
Hernando, MS 38632-1198

Mailing address

2007 Oak Tree CV
Suite 201
Hernando, MS 38632-1198
Phone (662) 429-8802

Other identifiers

IdentifierTypeStateIssuer
02403537MedicaidMS
P00175855OtherMSRAILROAD MEDICARE
0120120MedicaidMS
DC5472OtherMSCORP.GROUP
1003829680OtherMSNPI

Other providers in Hernando, MS

All providers in Hernando, MS · Point of Service in Mississippi

Sources for this page

Verify at the official NPI Registry.