Organization
PRIMESOURCE NURSING SERVICES, INC
Active
Parent organization
PRIMESOURCE NURSING SERVICES, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PRIMESOURCE NURSING SERVICES, INC
Authorized official
RHETT PLAUCHE (PRESIDENT)
(228) 865-1330
Entity
Organization
Contact information
Practice address
1500 BROAD AVE, GULFPORT, MS 39501-3601
(228) 865-1330
(228) 865-1331
Mailing address
PO BOX 6705, GULFPORT, MS 39506-6705
(228) 865-1330
(228) 865-1331
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
—
—
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
09/10/2018
Last updated
09/10/2018
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