Healthcare Provider Details

I. General information

NPI: 1750356721
Provider Name (Legal Business Name): OB SOLUTION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1855 LAKELAND DRIVE STE M10
JACKSON MS
39216
US

IV. Provider business mailing address

1855 LAKELAND DRIVE STE M10
JACKSON MS
39216
US

V. Phone/Fax

Practice location:
  • Phone: 601-829-4730
  • Fax: 601-213-5009
Mailing address:
  • Phone: 601-829-4730
  • Fax: 601-213-5009

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License NumberR805546
License Number StateMS

VIII. Authorized Official

Name: MRS. KATHERINE FELICE BLANCO
Title or Position: CLINIC ADMINISTRATOR
Credential:
Phone: 601-829-4730