Organization
ADVANCE CARE, LLC
Active
Other names
CareOne Medical Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
TYE ROLLINS (CFO, CLINICAL DIRECTOR)
(601) 397-4079
Entity
Organization
Contact information
Practice address
14 NORTHTOWN DR STE 105, JACKSON, MS 39211-3018
(601) 397-4079
Mailing address
14 NORTHTOWN DR STE 105, JACKSON, MS 39211-3018
(601) 397-4079
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
261QP2300X
Primary Care Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00855040
—
MS
Enumeration date
02/13/2018
Last updated
06/16/2018
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