Organization
PEACE WELLNESS CENTER, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. PAMELA JARRETT FNP,BC (CEO)
(601) 842-7107
Entity
Organization
Contact information
Practice address
638 NORTHWEST AVE, DURANT, MS 39063-3337
(601) 842-7107
(800) 517-7659
Mailing address
PO BOX 93, VAIDEN, MS 39176-0093
(601) 842-7107
(800) 517-7659
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
R869034
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03607748
—
MS
Enumeration date
03/15/2012
Last updated
03/15/2012
Update your record
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