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General NPI Number Information
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NPI Number | 1710823430
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Entity Type | Organization
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Legal Business Name | ADAN'S ENTERPRISE LLC
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Dates
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Enumeration Date | 04/25/2026
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Last Update Date | 04/28/2026
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Provider Practice Location Address
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Address Line | 274 SGT KEVIN GATSON AVE
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City | DURANT
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State | MS
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Zip | 39063-3635
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Country | US
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Telephone | 662-582-8376
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Fax |
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Provider Business Mailing Address
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Address Line | 274 SGT KEVIN GATSON AVE
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City | DURANT
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State | MS
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Zip | 39063-3635
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Country | US
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Telephone | 662-582-8376
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | PORSHIA CLARK
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Credential |
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Telephone | 662-582-8376
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number |
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License Number State |
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