Healthcare Provider Details

I. General information

NPI: 1376321570
Provider Name (Legal Business Name): TRUSTCARE KIDS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2023
Last Update Date: 09/19/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1651 W GOVERNMENT CV
BRANDON MS
39042-2410
US

IV. Provider business mailing address

1107 HIGHLAND COLONY PKWY STE 219
RIDGELAND MS
39157-6079
US

V. Phone/Fax

Practice location:
  • Phone: 601-487-4340
  • Fax: 601-487-4341
Mailing address:
  • Phone: 601-707-3279
  • Fax: 601-707-3598

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MR. WARREN HERRING
Title or Position: CEO
Credential:
Phone: 601-707-3279