Organization
POPLARVILLE SPECIAL SEPARATE MUNICIPAL SCHOOL DISTRICT
Active
Other names
Poplarville Lower Elementary EPSDT Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. LOUISE SMITH (SUPPORT STAFF SPECIALIST)
(601) 795-8477
Entity
Organization
Contact information
Practice address
804 S JULIA ST, POPLARVILLE, MS 39470-3017
(601) 795-8477
(601) 795-0712
Mailing address
804 S JULIA ST, POPLARVILLE, MS 39470-3017
(601) 795-8477
(601) 795-0712
Taxonomy
Speciality
Code
Description
License number
State
163WS0200X
School Registered Nurse
Primary
R859077
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016077
—
MS
Enumeration date
05/14/2007
Last updated
08/22/2020
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