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General NPI Number Information
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NPI Number | 1841447554
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Entity Type | Organization
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Legal Business Name | TOTAL CARE CLINIC
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Dates
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Enumeration Date | 08/25/2008
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Last Update Date | 08/25/2008
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Provider Practice Location Address
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Address Line | 526 DEERFIELD DR.
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City | FOREST
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State | MS
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Zip | 39074-9999
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Country | US
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Telephone | 601-469-0291
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Fax | 601-469-0347
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Provider Business Mailing Address
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Address Line | 526 DEERFIELD DR.
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City | FOREST
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State | MS
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Zip | 39074-9999
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Country | US
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Telephone | 601-469-0291
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Fax | 601-469-0347
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Authorized Official
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Title or Position | OWNER
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Name | MR. JOSEPH S MCNULTY
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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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