NPIMap

Organization Active NPI

Pec Referral Service Inc.

  • Respite Care
  • Greenville, MS
National Provider Identifier
1780831032
Registry record updated Feb 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Respite CareTaxonomy code 385H00000X
License
60609 Issued in MS
Legal business name
PEC REFERRAL SERVICE INC.
Practice address
2353 South Ridge Center
Box 121
Greenville, MS 38702-0121
Phone
(662) 334-6335
NPI assigned
Aug 19, 2008
Last updated
Feb 19, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2009

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

Authorized official

Name
Gwen Herman
Title
Owner
Phone
(662) 334-6335

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Respite Care 385H00000X 60609 MS Primary
Child Mental Illness Respite Care 385HR2055X 60609 MS
Child Intellectual and/or Developmental Disabilities Respite Care 385HR2060X 60609 MS
Child Physical Disabilities Respite Care 385HR2065X 60609 MS

Addresses

Primary practice location

2353 South Ridge Center
Box 121
Greenville, MS 38702-0121

Mailing address

2353 South Ridge Center
Box 121
Greenville, MS 38702-0121

Other identifiers 1

IdentifierTypeStateIssuer
00770569MedicaidMS

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1219104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1235001600000",
    "number": "1780831032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2353 SOUTH RIDGE CENTER",
            "address_2": "BOX 121",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387020121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2353 SOUTH RIDGE CENTER",
            "address_2": "BOX 121",
            "city": "GREENVILLE",
            "state": "MS",
            "postal_code": "387020121",
            "telephone_number": "662-334-6335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEC REFERRAL SERVICE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-19",
        "last_updated": "2009-02-19",
        "status": "A",
        "authorized_official_last_name": "HERMAN",
        "authorized_official_first_name": "GWEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "662-334-6335"
    },
    "taxonomies": [
        {
            "code": "385H00000X",
            "taxonomy_group": "",
            "desc": "Respite Care",
            "state": "MS",
            "license": "60609",
            "primary": true
        },
        {
            "code": "385HR2055X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Mental Illness, Child",
            "state": "MS",
            "license": "60609",
            "primary": false
        },
        {
            "code": "385HR2060X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child",
            "state": "MS",
            "license": "60609",
            "primary": false
        },
        {
            "code": "385HR2065X",
            "taxonomy_group": "",
            "desc": "Respite Care, Respite Care, Physical Disabilities, Child",
            "state": "MS",
            "license": "60609",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00770569",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, MS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 19, 2009; 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.