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General NPI Number Information
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NPI Number | 1972057222
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Entity Type | Organization
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Legal Business Name | PYCES ITS HEALTHCARE LLC
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Dates
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Enumeration Date | 08/04/2016
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Last Update Date | 08/04/2016
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Provider Practice Location Address
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Address Line | 310 W HARDING AVE
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City | GREENWOOD
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State | MS
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Zip | 38930-2925
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Country | US
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Telephone | 662-996-4760
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Fax | 662-219-0385
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Provider Business Mailing Address
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Address Line | 310 W HARDING AVE
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City | GREENWOOD
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State | MS
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Zip | 38930-2925
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Country | US
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Telephone | 662-996-4760
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Fax | 662-219-0385
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Authorized Official
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Title or Position | CHIEF OPERATING OFFICER
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Name | MR. DAVID LEVON GILBERT
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Credential |
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Telephone | 662-996-4760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 251T00000X
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Taxonomy Name | PACE Provider Organization
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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 | 251J00000X
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Taxonomy Name | Nursing Care Agency
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License Number |
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License Number State |
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