Healthcare Provider Details

I. General information

NPI: 1003465576
Provider Name (Legal Business Name): MEDREVIEW MANAGEMENT SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/08/2019
Last Update Date: 09/08/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

509 SPRINGRIDGE RD STE I
CLINTON MS
39056-5611
US

IV. Provider business mailing address

509 SPRINGRIDGE RD STE I
CLINTON MS
39056-5611
US

V. Phone/Fax

Practice location:
  • Phone: 601-488-9750
  • Fax:
Mailing address:
  • Phone: 601-488-9750
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code335G00000X
TaxonomyMedical Foods Supplier
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code246YC3301X
TaxonomyHospital Based Coding Specialist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code251300000X
TaxonomyLocal Education Agency (LEA)
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code343900000X
TaxonomyNon-emergency Medical Transport (VAN)
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code246YC3302X
TaxonomyPhysician Office Based Coding Specialist
License Number
License Number State

VIII. Authorized Official

Name: SHAHIRMARISHA BANKS
Title or Position: OWNER/OFFICE MANAGER
Credential:
Phone: 601-488-9750