Organization
PICAYUNE HOMECARE, LLC
Active
Other names
Mississippi HomeCare of Picayune
Organization subpart
No
Provider details
NPI number
Authorized official
NICHOLAS GACHASSIN (EXECUTIVE VICE PRESIDENT)
(337) 233-1307
Entity
Organization
Contact information
Practice address
1701 HIGHWAY 43 N, SUITE 6, PICAYUNE, MS 39466-2844
(601) 749-9101
(601) 749-8970
Mailing address
PO BOX 51266, LAFAYETTE, LA 70505-1266
(337) 233-1307
(337) 233-5764
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
2481
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00770551
—
MS
01
—
70217
BLUE CROSS BLUE SHIELD OF
MS
Enumeration date
07/09/2006
Last updated
07/12/2022
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