# MICARE, LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1154090157
- **Authorized official:** WILL MOON (CEO)
- **Authorized official phone:** (601) 988-3831

## Contact information

- **Practice address:** 10 CANEBRAKE BLVD STE 110-18, FLOWOOD, MS 39232-2211
- **Practice address phone:** (601) 286-1685
- **Mailing address:** 10 CANEBRAKE BLVD STE 110-18, FLOWOOD, MS 39232-2211
- **Mailing address phone:** (601) 286-1685

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 261QI0500X | Infusion Therapy Clinic/Center | — | NULL | — |
| 261QM1300X | Multi-Specialty Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 09/13/2021
- **Last updated:** 09/13/2021