Organization
A1 HEALTHCARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PRIMUS WHEELER JR. (OWNER)
(601) 362-9401
Entity
Organization
Contact information
Practice address
2570 BAILEY AVE, SUITE 1, JACKSON, MS 39213-6905
(601) 362-9401
(601) 366-5090
Mailing address
PO BOX 31055, JACKSON, MS 39286-1055
(601) 362-9401
(601) 366-5090
Taxonomy
Speciality
Code
Description
License number
State
332BX2000X
Oxygen Equipment & Supplies (DME)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00440424
—
MS
Enumeration date
04/23/2007
Last updated
06/13/2008
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