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General NPI Number Information
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NPI Number | 1629530795
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Entity Type | Organization
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Legal Business Name | A PORT IN THE STORM (APITS)
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Dates
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Enumeration Date | 04/05/2019
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Last Update Date | 06/16/2020
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Provider Practice Location Address
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Address Line | 102 N. CASS STREET, SUITE B
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City | CORINTH
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State | MS
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Zip | 38834
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Country | US
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Telephone | 855-427-4874
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Fax | 855-427-4874
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Provider Business Mailing Address
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Address Line | PO BOX 1498
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City | BOONEVILLE
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State | MS
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Zip | 38829-6498
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Country | US
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Telephone | 855-427-4874
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Fax | 855-427-4874
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Authorized Official
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Title or Position | PRESIDENT / PROGRAM MANAGER
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Name | DR. ELIZABETH NEWCOMB
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Credential | D.PSC.
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Telephone | 855-427-4874
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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