Healthcare Provider Details

I. General information

NPI: 1114188976
Provider Name (Legal Business Name): AFFORDABLE MEDICAL CARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2008
Last Update Date: 05/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 E COMMERCE ST
HERNANDO MS
38632-2433
US

IV. Provider business mailing address

PO BOX 326
HERNANDO MS
38632-0326
US

V. Phone/Fax

Practice location:
  • Phone: 662-429-9111
  • Fax: 662-429-6111
Mailing address:
  • Phone: 662-429-9111
  • Fax: 662-429-6111

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. SUNITA PAREEK
Title or Position: MANAGER
Credential:
Phone: 662-429-9111