Organization
PHOENIX SPECIALTYCARE, LLC
Active
Organization
PHOENIX SPECIALTYCARE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROLAND B WALL III (MANAGER)
(601) 932-3815
Entity
Organization
Contact information
Practice address
199 INTERSTATE DR, SUITE D, RICHLAND, MS 39218-4428
(601) 932-3815
Mailing address
199 INTERSTATE DR, SUITE D, RICHLAND, MS 39218-4428
(601) 932-3815
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
—
Other
Enumeration date
10/24/2006
Last updated
10/18/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up