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General NPI Number Information
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NPI Number | 1306182274
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Entity Type | Organization
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Legal Business Name | ON CALL NURSING AGENCY
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Dates
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Enumeration Date | 12/21/2012
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Last Update Date | 12/21/2012
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Provider Practice Location Address
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Address Line | 310 CAIN RIDGE RD A7
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City | VICKSBURG
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State | MS
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Zip | 39180-6054
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Country | US
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Telephone | 601-218-8930
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Fax | 601-218-8930
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Provider Business Mailing Address
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Address Line | 310 CAIN RIDGE RD A7
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City | VICKSBURG
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State | MS
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Zip | 39180-6054
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Country | US
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Telephone | 601-218-8930
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Fax |
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Authorized Official
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Title or Position | RN
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Name | MICHELLE L HAWKINS
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Credential | RN
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Telephone | 601-218-8930
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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License Number | R870313
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License Number State | MS
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Taxonomy #2
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number | R870313
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License Number State | MS
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