Organization
PHOENIX HEALTH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP A MARTINEZ (MANAGER)
(805) 709-2138
Entity
Organization
Contact information
Practice address
100 STREET A STE C, PICAYUNE, MS 39466-5459
(601) 373-3330
Mailing address
100 STREET A STE C, PICAYUNE, MS 39466-5459
(601) 373-3330
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
25D2113923
MS
Other
Enumeration date
10/11/2016
Last updated
10/11/2016
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