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General NPI Number Information
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NPI Number | 1366424897
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Entity Type | Organization
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Legal Business Name | PDN, INC.
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 08/24/2011
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Provider Practice Location Address
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Address Line | 10281 CORPORATE DR
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City | GULFPORT
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State | MS
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Zip | 39503-4603
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Country | US
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Telephone | 228-604-4550
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Fax | 228-604-4656
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Provider Business Mailing Address
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Address Line | 10278 CORPORATE DRIVE
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City | GULFPORT
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State | MS
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Zip | 39503-4603
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Country | US
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Telephone | 228-604-4550
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Fax | 228-604-4656
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | MRS. DONOR LYNN SKRNICH
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Credential |
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Telephone | 228-604-4550
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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 |
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License Number State |
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