Organization
COVENANT HEALTH & REHAB OF PICAYUNE, LP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JUDY ULLERY (PRESIDENT)
(901) 937-7994
Entity
Organization
Contact information
Practice address
1620 READ RD, PICAYUNE, MS 39466-2710
(601) 798-1811
(601) 798-2362
Mailing address
1620 READ RD, PICAYUNE, MS 39466-2710
(601) 798-1811
(601) 798-2362
Taxonomy
Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary
593
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0220283
—
MS
Enumeration date
05/11/2006
Last updated
08/10/2007
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