Organization
FOUNTAINS INFUSION CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GEORGE W PHILLIPS (MEMBER)
(601) 859-8200
Entity
Organization
Contact information
Practice address
159 FOUNTAINS BLVD STE D, MADISON, MS 39110-6344
(601) 859-8200
(601) 859-8201
Mailing address
159 FOUNTAINS BLVD STE D, MADISON, MS 39110-6344
(601) 859-8200
(601) 859-8201
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
—
—
Other
Enumeration date
04/30/2019
Last updated
04/30/2019
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