Organization
MANGUM MISSISSIPPI TRANSPORT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE DEANES MANGUM (OWNER)
(662) 605-0382
Entity
Organization
Contact information
Practice address
26237 W MAIN ST, WEST POINT, MS 39773-2749
(800) 982-3590
(800) 982-3590
Mailing address
29680 HIGHWAY 50 E, WEST POINT, MS 39773-5589
(662) 605-0382
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
06/15/2021
Last updated
06/15/2021
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