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General NPI Number Information
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NPI Number | 1891055588
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Entity Type | Organization
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Legal Business Name | HEALTH CARE FOR LIFE MS, LLC
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Dates
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Enumeration Date | 05/29/2012
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Last Update Date | 05/29/2012
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Provider Practice Location Address
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Address Line | 576 HIGHLAND COLONY PKWY SUITE 210
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City | RIDGELAND
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State | MS
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Zip | 39157-8769
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Country | US
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Telephone | 601-707-9488
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Fax |
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Provider Business Mailing Address
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Address Line | 576 HIGHLAND COLONY PKWY SUITE 210
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City | RIDGELAND
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State | MS
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Zip | 39157-8769
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Country | US
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Telephone | 601-707-9488
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Fax |
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Authorized Official
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Title or Position | PARTNER/MEMBER
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Name | DR. STUART M GREENBERG
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Credential | O.D.
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Telephone | 256-332-5440
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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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 | 213E00000X
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Taxonomy Name | Podiatrist
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 231H00000X
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Taxonomy Name | Audiologist
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number |
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License Number State |
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