Phoenix Healthcare, LLC

Primary specialty

Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X

Legal business name

PHOENIX HEALTHCARE, LLC

Practice address

606 South Laurel Street
Summit, MS 39666-9487

Phone

(601) 276-3132

Fax

(601) 276-3179

NPI assigned

Aug 18, 2009

Organization subpart

Yes

Parent organization

PHOENIX HEALTHCARE, LLCAs reported in NPPES

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

Authorized official

Name

Mr. Roland B Wall III

Title

Manager

Phone

(601) 932-3397

Specialties & licenses 1

Addresses

Part of

Phoenix Healthcare LLC

Locations

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

• Phoenix Healthcare, LLC

  • Durable Medical Equipment & Medical Supplies
  • Richland, MS
  • NPI 1730288507
  NPPES parent name

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

{
    "created_epoch": "1250553600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1250553600000",
    "number": "1962634337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "199 INTERSTATE DR",
            "address_2": "STE C",
            "city": "RICHLAND",
            "state": "MS",
            "postal_code": "392184428",
            "telephone_number": "601-932-3397",
            "fax_number": "601-932-3398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "606 SOUTH LAUREL STREET",
            "city": "SUMMIT",
            "state": "MS",
            "postal_code": "396669487",
            "telephone_number": "601-276-3132",
            "fax_number": "601-276-3179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HEALTHCARE, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PHOENIX HEALTHCARE, LLC",
        "enumeration_date": "2009-08-18",
        "last_updated": "2009-08-18",
        "status": "A",
        "authorized_official_last_name": "WALL",
        "authorized_official_first_name": "ROLAND",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "601-932-3397",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Phillips
• Brandi Phillips
• Julie Phillips, COTA/L
• Kailee Ann Phillips, M.S., CF-SLP
• Tiffany Phillips
• Christie Pierce
• Dianna Pinkerton
• Pinnacle Medical Clinic Inc
• Pixies Pantry, LLC
• Jordan Spears Porter, MS, CCC-SLP

• Durable Medical Equipment & Medical Supplies in Summit, MS
• Providers in Summit, MS by specialty
• Durable Medical Equipment & Medical Supplies in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.