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General NPI Number Information
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NPI Number | 1801659438
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Entity Type | Organization
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Legal Business Name | PLG RESOURCE AGENCY
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Dates
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Enumeration Date | 02/05/2024
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Last Update Date | 02/05/2024
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Provider Practice Location Address
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Address Line | 3340 GREENWAY DR
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City | HORN LAKE
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State | MS
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Zip | 38637-2642
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Country | US
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Telephone | 573-481-5473
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Fax |
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Provider Business Mailing Address
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Address Line | 3340 GREENWAY DR
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City | HORN LAKE
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State | MS
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Zip | 38637-2642
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Country | US
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Telephone | 573-481-5473
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | ERICA WHITE
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Credential |
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Telephone | 573-481-5473
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 342000000X
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Taxonomy Name | Transportation Network Company
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 347E00000X
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Taxonomy Name | Transportation Broker
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License Number |
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License Number State |
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