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Organization
MICARE, LLC
Active
Organization
MICARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILL MOON (CEO)
(601) 988-3831
Entity
Organization
Contact information
Practice address
10 CANEBRAKE BLVD STE 110-18, FLOWOOD, MS 39232-2211
(601) 286-1685
Mailing address
10 CANEBRAKE BLVD STE 110-18, FLOWOOD, MS 39232-2211
(601) 286-1685
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
—
NULL
207P00000X
Emergency Medicine Physician
—
—
261QI0500X
Infusion Therapy Clinic/Center
—
NULL
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/13/2021
Last updated
09/13/2021
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