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General NPI Number Information
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NPI Number | 1669743233
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Entity Type | Organization
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Legal Business Name | PIONEER HEALTH SERVICES OF NEWTON COUNTY, LLC
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Dates
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Enumeration Date | 01/13/2012
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Last Update Date | 01/13/2012
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Provider Practice Location Address
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Address Line | 9427 EASTSIDE DRIVE EXT. SUITE A
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City | NEWTON
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State | MS
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Zip | 39345
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Country | US
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Telephone | 601-849-6440
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 1100
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City | MAGEE
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State | MS
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Zip | 39111-1100
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Country | US
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Telephone | 601-849-6440
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | JOSEPH S. MCNULTY III
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Credential |
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Telephone | 601-849-6440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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