Phoenix Specialtycare, LLC
NPI #1053495515 in Richland, Mississippi
Provider Information
- NPI Number
- 1053495515
- Entity Type
- Organization
- Organization Name
- Phoenix Specialtycare, LLC
- Primary Specialty
- Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition
- Enumeration Date
- Oct 24, 2006
- Last Updated
- Oct 18, 2007
Practice Location
- Address
- 199 INTERSTATE DR
- Address 2
- SUITE D
- City
- Richland
- State
- Mississippi
- ZIP Code
- 39218-4428
- Phone
- (601) 932-3815
Authorized Official
- Name
- MR. ROLAND B WALL III
- Title
- MANAGER
- Phone
- (601) 932-3815
Specialties & Taxonomy Codes
| Specialty |
|---|
| Durable Medical Equipment & Medical Supplies - Parenteral & Enteral Nutrition — Parenteral & Enteral Nutrition |
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