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Organization

NUTRITION CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
CINDY SMITH RD (OWNER)
(662) 869-3700
Entity
Organization

Contact information

Practice address
306 CR 521, SALTILLO, MS 38866
(662) 869-3700
Mailing address
PO BOX 79, SALTILLO, MS 38866-0079
(662) 869-3700

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
D0510
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3021712646
MEDICARE
MS
Enumeration date
02/01/2013
Last updated
11/07/2016
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