Provider Demographics
NPI:1114206422
Name:UC, LLC
Entity Type:Organization
Organization Name:UC, LLC
Other - Org Name:TRUSTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:BUSINESS OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:WARREN
Authorized Official - Middle Name:
Authorized Official - Last Name:HERRING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:601-368-9950
Mailing Address - Street 1:PO BOX 16436
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39236-6436
Mailing Address - Country:US
Mailing Address - Phone:601-368-9950
Mailing Address - Fax:601-368-9975
Practice Address - Street 1:1067 HIGHLAND COLONY PARKWAY
Practice Address - Street 2:SUITE N
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39157
Practice Address - Country:US
Practice Address - Phone:601-368-9950
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-04
Last Update Date:2011-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty