Provider Demographics
NPI:1235529298
Name:CAFFEY CLINIC LLC
Entity Type:Organization
Organization Name:CAFFEY CLINIC LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF HEALTH SERVICES
Authorized Official - Prefix:MRS
Authorized Official - First Name:JENNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PRYOR
Authorized Official - Suffix:
Authorized Official - Credentials:RN
Authorized Official - Phone:662-562-0100
Mailing Address - Street 1:PO BOX 531
Mailing Address - Street 2:
Mailing Address - City:SENATOBIA
Mailing Address - State:MS
Mailing Address - Zip Code:38668-0531
Mailing Address - Country:US
Mailing Address - Phone:662-562-0100
Mailing Address - Fax:662-562-6518
Practice Address - Street 1:3297 HIGHWAY 51 S
Practice Address - Street 2:
Practice Address - City:SENATOBIA
Practice Address - State:MS
Practice Address - Zip Code:38668-2926
Practice Address - Country:US
Practice Address - Phone:662-562-0100
Practice Address - Fax:662-562-0115
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-29
Last Update Date:2022-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty