1154423457 NPI number — PROFESSIONAL THERAPY SERVICES INC

Table of content: (NPI 1154423457)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154423457 NPI number — PROFESSIONAL THERAPY SERVICES INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PROFESSIONAL THERAPY SERVICES INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1154423457
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1050 RIVER OAKS DR
Provider Second Line Business Mailing Address:
SUITE 110
Provider Business Mailing Address City Name:
FLOWOOD
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
39232-9564
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
601-366-3400
Provider Business Mailing Address Fax Number:
601-366-3439

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1050 RIVER OAKS DR
Provider Second Line Business Practice Location Address:
SUITE 110
Provider Business Practice Location Address City Name:
FLOWOOD
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
39232-9564
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
601-366-3400
Provider Business Practice Location Address Fax Number:
601-366-3439
Provider Enumeration Date:
09/05/2006

Additional Information

Authorized Official

Authorized Official Last Name:
THOMAS
Authorized Official First Name:
WILLIAM
Authorized Official Middle Name:
R
Authorized Official Title or Position:
OWNER, V PRESIDENT
Authorized Official Telephone Number:
601-366-3400

Provider Taxonomy Codes

  • Taxonomy code: 225100000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 1710978515 . This is a "K HILL NPI PROVIDER #" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 1801883095 . This is a "M HILL NPI PROVIDER #" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 1134124845 . This is a "J MORGAN NPI PROVIDER #" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 1710982673 . This is a "M FULTON NPI PROVIDER #" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 9016307 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9015664 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 9015705 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".
  • Identifier: 1295731685 . This is a "B THOMAS NPI PROVIDER #" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 1518962471 . This is a "S ATKINS NPI PROVIDER #" identifier , issued by the state of ( AL ) . This identifiers is of the category "OTHER".
  • Identifier: 1558366252 . This is a "D FULTON NPI PROVIDER #" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 1174528871 . This is a "C CLARK NPI PROVIDER #" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".




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