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1467561670 NPI number — ALCORN REHAB SERVICES INC

NPI Number: 1467561670
Health Care Provider/Practitioner: ALCORN REHAB SERVICES INC

Information about “1467561670” NPI (ALCORN REHAB SERVICES INC) exists in 1467561670 in HTML format HTML  |  1467561670 in plain Text format TXT  |  1467561670 in PDF (Portable Document Format) PDF  |  1467561670 in an XML format XML  formats.

NPI Number : 1467561670 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1467561670",
    "EntityType": "Organization",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": null,
    "IsOrgSubpart": "N",
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": "ALCORN REHAB SERVICES INC",
    "LastName": null,
    "FirstName": null,
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1708 E SHILOH RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "CORINTH",
    "MailingAddressStateName": "MS",
    "MailingAddressPostalCode": "38834-3635",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "662-284-4656",
    "MailingAddressFaxNumber": "662-665-0836",
    "FirstLinePracticeLocationAddress": "1708 E SHILOH RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "CORINTH",
    "PracticeLocationAddressStateName": "MS",
    "PracticeLocationAddressPostalCode": "38834-3635",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "662-284-4656",
    "PracticeLocationAddressFaxNumber": "662-665-0836",
    "EnumerationDate": "08/30/2006",
    "LastUpdateDate": "04/20/2008",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": null,
    "Gender": null,
    "AuthorizedOfficialLastName": "STEWART",
    "AuthorizedOfficialFirstName": "MICHAEL",
    "AuthorizedOfficialMiddleName": "LEE",
    "AuthorizedOfficialTitle": "OWNER/PT",
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": "PHYSICAL THERAPIST",
    "AuthorizedOfficialTelephoneNumber": "662-284-4656",
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "332B00000X",
          "TaxonomyName": "Durable Medical Equipment & Medical Supplies",
          "LicenseNumber": "5927860001",
          "LicenseNumberStateCode": "MS",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "261QP2000X",
          "TaxonomyName": "Physical Therapy Clinic/Center",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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