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Organization
PICAYUNE HOMECARE, LLC
Active
Organization
PICAYUNE HOMECARE, LLC
Active
Other names
Mississippi HomeCare of Picayune
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS GACHASSIN (EXECUTIVE VICE PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
1701 HIGHWAY 43 N, SUITE 6, PICAYUNE, MS 39466-2844
(601) 749-9101
(601) 749-8970
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2481
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770551
—
MS
01
—
70217
BLUE CROSS BLUE SHIELD OF
MS
Enumeration date
07/09/2006
Last updated
07/12/2022
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