Healthcare Provider Details

I. General information

NPI: 1659011567
Provider Name (Legal Business Name): PARKWAY HEALTH & REHAB, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2022
Last Update Date: 03/30/2022
Certification Date: 03/17/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 RIVER OAKS DRIVE
CANTON MS
39046-3904
US

IV. Provider business mailing address

13 NORTHTOWN DR STE 220
JACKSON MS
39211-3047
US

V. Phone/Fax

Practice location:
  • Phone: 601-956-8276
  • Fax: 601-709-0832
Mailing address:
  • Phone: 601-956-8276
  • Fax: 601-709-0832

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: REBECCA SHELTON
Title or Position: MANAGER/SECRETARY
Credential:
Phone: 601-956-8276