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General NPI Number Information
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NPI Number | 1568777977
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Entity Type | Organization
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Legal Business Name | PIONEER HEALTH SERVICES OF NEWTON COUNTY
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Dates
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Enumeration Date | 08/10/2010
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Last Update Date | 09/15/2010
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Provider Practice Location Address
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Address Line | 9421 EASTSIDE DRIVE EXT
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City | NEWTON
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State | MS
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Zip | 39345-8063
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Country | US
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Telephone | 601-683-2031
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Fax | 601-683-0264
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Provider Business Mailing Address
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Address Line | 9421 EASTSIDE DRIVE EXT
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City | NEWTON
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State | MS
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Zip | 39345-8063
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Country | US
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Telephone | 601-683-2031
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Fax | 601-683-0264
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Authorized Official
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Title or Position | PRESIDENT
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Name | JOSEPH S MCNULTY III
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Credential |
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Telephone | 601-849-1682
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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