Healthcare Provider Details

I. General information

NPI: 1306778824
Provider Name (Legal Business Name): DESTIN HEALTHCARE INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 05/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4612 MEDGAR EVERS BLVD STE 10
JACKSON MS
39213-5205
US

IV. Provider business mailing address

4612 MEDGAR EVERS BLVD STE 10
JACKSON MS
39213-5205
US

V. Phone/Fax

Practice location:
  • Phone: 601-249-9868
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332BN1400X
TaxonomyNursing Facility Supplies (DME)
License Number
License Number State

VIII. Authorized Official

Name: DEJA M ALMORE
Title or Position: EXECUTIVE DIRECTOR
Credential:
Phone: 601-249-9868