Organization
PHOENIX HEALTHCARE, LLC
Active
Parent organization
PHOENIX HEALTHCARE, LLC
Organization subpart
Yes
Provider details
NPI number
Legal business name
PHOENIX HEALTHCARE, LLC
Authorized official
MR. ROLAND B WALL III (MANAGER)
(601) 932-3397
Entity
Organization
Contact information
Practice address
606 SOUTH LAUREL STREET, SUMMIT, MS 39666-9487
(601) 276-3132
(601) 276-3179
Mailing address
199 INTERSTATE DR, STE C, RICHLAND, MS 39218-4428
(601) 932-3397
(601) 932-3398
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/18/2009
Last updated
08/18/2009
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