Provider Demographics
NPI:1295824100
Name:BETTER LIVING ENDOSCOPY CENTER
Entity Type:Organization
Organization Name:BETTER LIVING ENDOSCOPY CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YOSHINOBU
Authorized Official - Middle Name:
Authorized Official - Last Name:NAMIHIRA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:601-638-9800
Mailing Address - Street 1:3000 HALLS FERRY RD
Mailing Address - Street 2:
Mailing Address - City:VICKSBURG
Mailing Address - State:MS
Mailing Address - Zip Code:39180-4802
Mailing Address - Country:US
Mailing Address - Phone:601-638-9800
Mailing Address - Fax:601-638-9808
Practice Address - Street 1:3000 HALLS FERRY RD
Practice Address - Street 2:
Practice Address - City:VICKSBURG
Practice Address - State:MS
Practice Address - Zip Code:39180-4802
Practice Address - Country:US
Practice Address - Phone:601-638-9800
Practice Address - Fax:601-638-9808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-11
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00770129Medicaid
LA1685445Medicaid
LA1685445Medicaid