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General NPI Number Information
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NPI Number | 1922735604
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Entity Type | Organization
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Legal Business Name | BLUEHEALTH LLC
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Dates
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Enumeration Date | 08/03/2022
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Last Update Date | 08/03/2022
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Provider Practice Location Address
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Address Line | 3545 LAKELAND DR
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City | FLOWOOD
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State | MS
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Zip | 39232-8839
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Country | US
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Telephone | 601-664-4724
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Fax |
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Provider Business Mailing Address
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Address Line | 3545 LAKELAND DR
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City | FLOWOOD
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State | MS
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Zip | 39232-8839
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Country | US
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Telephone | 601-664-4724
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Fax |
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Authorized Official
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Title or Position | CORPORATE ATTORNEY
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Name | THOMAS MICHAEL CRONIN
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Credential | J.D.
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Telephone | 601-664-4724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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