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General NPI Number Information
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NPI Number | 1467593012
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Entity Type | Organization
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Legal Business Name | PITTS NURSING CARE
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Dates
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Enumeration Date | 02/08/2007
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Last Update Date | 06/27/2008
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Provider Practice Location Address
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Address Line | 416 WESTSIDE AVE
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City | INDIANOLA
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State | MS
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Zip | 38751-2752
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Country | US
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Telephone | 662-207-4225
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Fax | 662-207-1856
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Provider Business Mailing Address
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Address Line | 416 WESTSIDE AVE 203 HERMON JOHNSON
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City | INDIANOLA
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State | MS
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Zip | 38751-2752
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Country | US
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Telephone | 662-207-4225
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Fax | 662-887-2374
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Authorized Official
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Title or Position | ONWER
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Name | MS. DIANA PITTS
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Credential | RN
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Telephone | 662-207-4225
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State | MS
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